NPI | 1952796484 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN FAGAN Owner/Md 706-863-9595 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 208600000X Surgery |
Enumeration Date | 2015-04-01 |
Last Update Date | 2022-10-11 |