Midwest Emergency Sparta, INC

NPI #1194162370 in Sparta, Illinois

Provider Information

NPI Number: 1194162370
Entity Type: Organization
Organization Name: Midwest Emergency Sparta, INC
Primary Specialty: Emergency Medicine
Enumeration Date: May 29, 2013
Last Updated: May 29, 2013

Practice Location

Address: 818 E BROADWAY ST
City: Sparta
State: Illinois
ZIP Code: 62286-1820
Phone: (817) 451-4208

Authorized Official

Name: DR. WILLIAM W CRUZEN, MD
Title: OWNER/PRESIDENT
Phone: (817) 451-4208

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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