| Laura Bird, Md, Llc | |
|
2704 N Center St Maryville IL 62062-5624 | |
| (618) 288-0656 | |
| (618) 288-0736 |
| Full Name | Laura Bird, Md, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2704 N Center St, Maryville, Illinois |
| Authorized Official Name and Position | David Bird (OFFICE MANAGER) |
| Authorized Official Contact | 6182880656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Bird, Md, Llc 2704 N Center St Maryville IL 62062-5624 Ph: (618) 288-0656 | Laura Bird, Md, Llc 2704 N Center St Maryville IL 62062-5624 Ph: (618) 288-0656 |
| NPI Number | 1083734610 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 07/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083734610 | NPI | - | NPPES |
| 036096129 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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