| NPI | 1811186216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEE DEE GIBBY Billing Department 706-745-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 053008) |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2010-03-23 |