| NPI | 1821004532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD V JOHNSON Vice President 601-346-5058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |