| NPI | 1841548427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODIE COLWELL CFO 870-460-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207RX0202X Internal Medicine Medical Oncology |
| 208600000X Surgery | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2022-09-20 |