| NPI | 1770186702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD INGRAM Administrator 601-420-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2021-01-13 |