| NPI | 1952589095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE KING Provider Enrollment 601-351-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MS 31-139) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |