# BEL CLAIR AMBULATORY SURGICAL TREATMENT CENTER, LTD

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

## Provider details

- **NPI number:** 1720458813
- **Authorized official:** MR. DAVID RUSSELL HORACE (ADMINISTRATOR)
- **Authorized official phone:** (618) 235-2299

## Contact information

- **Practice address:** 325 W LINCOLN ST, BELLEVILLE, IL 62220-1921
- **Practice address phone:** (618) 235-2299
- **Practice address fax:** (618) 235-2556
- **Mailing address:** 325 W LINCOLN ST, BELLEVILLE, IL 62220-1921
- **Mailing address phone:** (618) 235-2299
- **Mailing address fax:** (618) 235-2556

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | IL | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | IL | — |

## Other

- **Enumeration date:** 10/01/2015
- **Last updated:** 10/01/2015