| NPI | 1770620403 |
|---|---|
| Other Name | DIAMONDHEAD FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | CHELE M WALLEY Billing Manager 228-255-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 11771) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |