Gcxp INC

NPI #1346749090 in O Fallon, Illinois

Provider Information

NPI Number: 1346749090
Entity Type: Organization
Organization Name: Gcxp INC
Primary Specialty: Emergency Medicine
Enumeration Date: Feb 8, 2018
Last Updated: Feb 8, 2018

Practice Location

Address: 1 SAINT ELIZABETH BLVD
City: O Fallon
State: Illinois
ZIP Code: 62269-1099
Phone: (618) 234-2120

Authorized Official

Name: CARMON L GLOVER III, DO
Title: AUTHORIZED OFFICIAL
Phone: (888) 577-6337

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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