| NPI | 1720123003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL D SHEPHERD Clinic Manager 228-374-1894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 17226) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |