Graduated: 2002
NPI: 1295932168
Practice Locations (2)
HATTIESBURG CLINIC PA
415 S 28TH AVE
HATTIESBURG, MS 394017246
6012646000
INTEGRIS AMBULATORY CARE CORPORATION
3300 NW EXPRESSWAY
OKLAHOMA CITY, OK 731124418
4059493141
Source: CMS National Downloadable File, September 2026.