| NPI | 1770929713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES NAURICE CRENSHAW Owner/Physican 601-992-6511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 09099) |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2013-05-29 |