| NPI | 1861531915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE TYSON Office Manager 229-243-0152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 22631) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA 023914) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |