| NPI | 1982897492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE L WARDLAW President/Physician 901-396-0311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TN MD000008559) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2008-01-18 |