| NPI | 1720443351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN FORD Associate Medical Director 228-860-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 901480) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2016-03-23 |