| NPI | 1770758724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN E DOBSON CFO 906-265-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207P00000X Emergency Medicine | |
| 207R00000X Internal Medicine | |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2008-04-29 |