Southern Illinois Urology

NPI #1417144726 in Marion, Illinois

Provider Information

NPI Number: 1417144726
Entity Type: Organization
Organization Name: Southern Illinois Urology
Primary Specialty: Specialist
Enumeration Date: Oct 1, 2007
Last Updated: Oct 1, 2007

Practice Location

Address: 3401 HEARTLAND ST
City: Marion
State: Illinois
ZIP Code: 62959-6393
Phone: (618) 998-8884

Authorized Official

Name: DR. ROBERT LAWRENCE HATCHETT, M.D.
Title: OWNER
Phone: (618) 998-8884

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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