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>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1306819545

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
33700 HWY 43 STE. E THOMASVILLE, AL 36784-3555 US
Tel: 334-636-4431  Fax: 334-636-6129

Contact information for business:
7523 WEIL AVE  SAINT LOUIS, MO 63119-3311 US
Tel: --  Fax: --

Registration Information:
NPI: 1306819545
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine

Legacy codes, insurance codes and state license numbers:



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