| NPI | 1740957216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE TOPPIN Corporate Secretary 662-377-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 1041C0700X Social Worker Clinical | |
| 207QA0505X Family Medicine Adult Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |