| NPI | 1942408216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL L STEPHENS Owner 706-863-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 040246) |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2013-01-22 |