| St. Marys Good Samaritan Medical Group Ultrasound | |
|
1708 Jefferson Ave Suite 100 Mount Vernon IL 62864-4309 | |
| (618) 241-1856 | |
| (618) 241-1857 |
| Full Name | St. Marys Good Samaritan Medical Group Ultrasound |
|---|---|
| Speciality | Clinic/center |
| Location | 1708 Jefferson Ave, Mount Vernon, Illinois |
| Authorized Official Name and Position | Richard Huntington (VP FINANCIAL SERVICES) |
| Authorized Official Contact | 6182412204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Marys Good Samaritan Medical Group Ultrasound 413 Main St Mount Vernon IL 62864-3649 Ph: (618) 532-9350 | St. Marys Good Samaritan Medical Group Ultrasound 1708 Jefferson Ave Suite 100 Mount Vernon IL 62864-4309 Ph: (618) 241-1856 |
| NPI Number | 1316271653 |
|---|---|
| Provider Enumeration Date | 09/18/2009 |
| Last Update Date | 09/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316271653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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