# MARION EYE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346698602
- **Authorized official:** DR. MAQBOOL AHMAD M.D. (PRESIDENT)
- **Authorized official phone:** (618) 993-5686

## Contact information

- **Practice address:** 2900 BROADWAY ST, STE. B, MOUNT VERNON, IL 62864-2341
- **Practice address phone:** (618) 969-8700
- **Practice address fax:** (618) 899-9020
- **Mailing address:** PO BOX 1178, MARION, IL 62959-7678
- **Mailing address phone:** (618) 969-8777
- **Mailing address fax:** (618) 997-6250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7003143 | IL | Yes |

## Other

- **Enumeration date:** 05/27/2016
- **Last updated:** 05/27/2016