| NPI | 1639271513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT WILLIAM O'DELL President 618-233-5998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: IL 036064291) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-10-09 |