| NPI | 1932553245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DANIEL SAUL Physician 601-512-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MS 22764) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-09-28 |