Internal Medicine O F Highland

NPI #1568407146 in Maryville, Illinois

Provider Information

NPI Number: 1568407146
Entity Type: Organization
Organization Name: Internal Medicine O F Highland
Primary Specialty: Internal Medicine
Enumeration Date: Jun 18, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 6810 STATE ROUTE 162
Address 2: SUITE 109
City: Maryville
State: Illinois
ZIP Code: 62062-8501
Phone: (618) 288-0030

Authorized Official

Name: DR. SCOTT A. HALVORSON, M.D.
Title: PRESIDENT
Phone: (618) 288-0030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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