| NPI | 1982963872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY ROUSE CFO 901-507-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 207R00000X Internal Medicine | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2022-05-02 |