| NPI | 1720301732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN JUDSON KITCHINGS Owner/President 228-863-6883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 03606) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2012-05-23 |