Organization
OSWALT GENERAL SURGERY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTOPHER MICHAEL OSWALT M.D (M.D.)
(815) 513-5650
Entity
Organization
Contact information
Practice address
942 W ROUTE 6, MORRIS, IL 60450-8858
(815) 513-5650
(815) 513-5652
Mailing address
942 W ROUTE 6, MORRIS, IL 60450-8858
(815) 513-5650
(815) 513-5652
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036.119946
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119946
—
IL
01
—
217073
MEDICARE TTAN
—
Enumeration date
07/17/2008
Last updated
07/18/2011
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