| NPI | 1871058792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E MCCARVILLE Administrator 662-432-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2020-02-21 |