| NPI | 1831240928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMI C. ADAMS Credentialing Specialist 228-818-5521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 016) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2016-11-16 |