Advanced Urologic Surgeons Pc

NPI 1093901340 - Specialist - 174400000X

NPI Details
NPI 1093901340
Enumeration Date 09/20/2007
Last Updated 04/29/2010
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name DAVID DAVID
Position OWNER
Phone (618) 244-4060
Fax (618) 244-4061
Practice Location
604 SEVILLE DR
MOUNT VERNON IL, 62864-7001, US
Phone (618) 244-4060
Fax (618) 244-4061
Business Location
604 SEVILLE DR
MOUNT VERNON IL, 62864-7001, US
Phone (618) 244-4060
Fax (618) 244-4061
Toxanomy
Taxonomy Code 174400000X
License State Illinois
License Number 036114878
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According to our database, Advanced Urologic Surgeons Pc NPI is 1093901340, taxonomy code is 174400000X and license number is 036114878, license state is located at Illinois. Advanced Urologic Surgeons Pc physically located at 604 Seville Dr, Mount Vernon IL, 62864-7001. NPI Number 1033115704 has the healthcare provider type.

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1093901340 NPI number is provided on an as is basis without warranty of any kind. 1093901340 is maintained by the National Plan & Provider Enumeration System. The contents of Advanced Urologic Surgeons Pc are for informational purposes only.