| NPI | 1760562268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY J BRICKLE Billing Agent 478-254-5943 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 018579) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2010-07-28 |