| Maryville Medical Services, Llc | |
|
6810 State Route 162 Suite 215 Maryville IL 62062-8501 | |
| (618) 288-5711 | |
| (618) 288-4088 |
| Full Name | Maryville Medical Services, Llc |
|---|---|
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 6810 State Route 162, Maryville, Illinois |
| Authorized Official Name and Position | Keith Page (CEO) |
| Authorized Official Contact | 6182885711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryville Medical Services, Llc 6810 State Route 162 Suite 215 Maryville IL 62062-8501 Ph: (618) 288-5711 | Maryville Medical Services, Llc 6810 State Route 162 Suite 215 Maryville IL 62062-8501 Ph: (618) 288-5711 |
| NPI Number | 1780614669 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780614669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | (* (Not Available)) | Primary |
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