| NPI | 1831412519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN M LANGSTON Practice Manager 270-887-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2018-04-26 |