| NPI | 1881021350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEGGY LORRAINE NOONAN Physician Business Services Dir. 228-575-1740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2024-01-09 |