| NPI | 1821427246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ALLEN LEE Chief Executive Officer 229-200-4019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2013-11-06 |