| NPI | 1720821861 |
|---|---|
| Doing Business As | DERMATOLOGY-PETAL |
| Entity Type | Organization |
| Authorized Contact | BRYAN N BATSON Executive Director 601-268-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |