| NPI | 1851349070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG J. GAVIN Network Administrator 318-212-4571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2012-06-08 |