| NPI | 1912280694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILBERT FORTSON CEO 912-721-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VM0101X Obstetrics & Gynecology, Maternal & Fetal Medicine (Licence: GA 57459) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2011-09-20 |