NPI | 1972709152 |
---|---|
Former Legal Business Name | DEJO VIPRAKASIT, MD |
Entity Type | Organization |
Authorized Contact | TERESA M. BLANKENSHIP Office Manager 901-476-1135 |
Organization Subpart ? | No |
Primary Taxonomy | 208800000X Urology |
Enumeration Date | 2007-06-25 |
Last Update Date | 2007-08-14 |