| NPI | 1871687749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA LEIGH COX Office Manager 662-678-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R697621) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R853933) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-05-21 |