| NPI | 1952741720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT HICKS THOMPSON Owner/Physician 912-265-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 005648) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |