| NPI | 1821268467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI AVERY Office Manager 662-327-3195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: MS 13124) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2012-07-20 |