Southern Illinois Pain Management

NPI #1942227863 in Marion, Illinois

Provider Information

NPI Number: 1942227863
Entity Type: Organization
Organization Name: Southern Illinois Pain Management
Primary Specialty: Specialist
Enumeration Date: Jul 16, 2006
Last Updated: Jan 18, 2011

Practice Location

Address: 3905 W ERNESTINE DR
City: Marion
State: Illinois
ZIP Code: 62959-5800
Phone: (618) 993-5859

Authorized Official

Name: MR. PAUL BRIAN JUERGENS, M.D
Title: OWNER/PHYSICIAN
Phone: (618) 993-5859

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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