| NPI | 1710389440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI JOHNSON Practice Administrator 229-432-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA RN205498) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |