| NPI | 1235474057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES B. DAVIS Executive Director 618-257-6302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RC0001X Internal Medicine Clinical Cardiac Electrophysiology | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RS0010X Internal Medicine Sports Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| 2086S0129X Surgery Vascular Surgery | |
| 208800000X Urology | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |