| NPI | 1902885874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH B FILLMORE CEO 334-793-5105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2022-07-21 |