| NPI | 1891398996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINSTON PRICE Medical Director 229-220-5674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |