| NPI | 1851620421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD KIMBROUGH Manager 662-377-4685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2014-06-02 |