| NPI | 1720660095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BEACHAM Owner 601-918-5567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2021-04-26 |
| Last Update Date | 2022-06-01 |