| NPI | 1902277429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN ISOM CEO 901-854-7363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2015-10-09 |