| NPI | 1750829107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMERALD I HALL Owner 912-208-0726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine | |
| 208D00000X General Practice | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |