| NPI | 1629386586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES B. DAVIS Executive Director 618-257-4644 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2022-07-21 |