| NPI | 1437109766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRIE K WEITH Business Advisor 618-779-5508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-08-22 |