| NPI | 1902538259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD HATHCOCK Owner 901-497-3805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2022-06-27 |