| NPI | 1750387833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M. FENDLEY President 334-793-1534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL 0074230) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: AL 0074230) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2020-08-22 |