| NPI | 1922321546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES B. DAVIS Executive Director 618-257-6301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 208800000X Urology |
| 207RG0100X Internal Medicine, Gastroenterology | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2014-01-09 |