| NPI | 1912650318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANEY L HIPPLER Regional Director Of Clinic Ops 318-315-7093 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |