Grenada Lake Inpatient Medicine Associates
NPI #1235284928 in Grenada, Mississippi
Provider Information
- NPI Number
- 1235284928
- Entity Type
- Organization
- Organization Name
- Grenada Lake Inpatient Medicine Associates
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Jan 24, 2007
- Last Updated
- Apr 20, 2008
Practice Location
- Address
- 960 J K AVENT DR
- City
- Grenada
- State
- Mississippi
- ZIP Code
- 38901-5230
- Phone
- (662) 227-7492
Authorized Official
- Name
- KEITH HEARTSILL
- Title
- CFO
- Phone
- (662) 227-7172
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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