| NPI | 1912906157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID M. BURCKEL CEO 601-554-7525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MS 015) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2009-12-28 |