| NPI | 1700064797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA BROWN JACKSON Owner/Physician 812-858-1957 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01037696A) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002200A) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-01 |