| NPI | 1770789349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY D BURKE Physician 901-683-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: TN 0000010602) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-22 |