| NPI | 1366543084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY CARTER Office Administrator 618-993-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 213E00000X Podiatrist |
| 207P00000X Emergency Medicine | |
| 207Q00000X Family Medicine | |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207V00000X Obstetrics & Gynecology | |
| 207Y00000X Otolaryngology | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 208800000X Urology | |
| 261QR0200X Clinic/Center, Radiology | |
| 261QR1300X Clinic/Center, Rural Health | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2022-09-08 |