Eye Specialist of Southern Illinois, LLC

NPI #1528020401 in Marion, Illinois

Provider Information

NPI Number: 1528020401
Entity Type: Organization
Organization Name: Eye Specialist of Southern Illinois, LLC
Primary Specialty: Ophthalmology
Enumeration Date: Apr 5, 2006
Last Updated: Oct 3, 2007

Practice Location

Address: 1000 W DEYOUNG ST
City: Marion
State: Illinois
ZIP Code: 62959-1630
Phone: (618) 993-0068

Authorized Official

Name: DAVID C ANDERSON
Title: PRACTICE ADMINISTRATOR
Phone: (573) 335-9175

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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