NPI | 1801063698 |
---|---|
Entity Type | Organization |
Authorized Contact | TOMMY WARREN SHELTON Owner/Physician 606-425-4298 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2008-05-12 |
Last Update Date | 2014-03-05 |