| NPI | 1851778823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY MILES BUTLER Owner 912-278-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2019-08-07 |