| NPI | 1770456279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY B MAROTTE Md 501-327-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-10-09 |