| NPI | 1902957483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELL C CHOATE Administrator 601-684-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 25C0001019) |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2008-05-20 |