Individual
DR. SCOTT ERIC URCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
503 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-5917
Mailing address
503 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-5917
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01062567A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000488866
ANTHEM BCBS
IN
01
—
DB9030
RAILROAD MEDICARE GROUP NUMBER
GA
01
—
P00479061
RAILROAD MEDICARE PTAN
GA
Enumeration date
12/28/2005
Last updated
02/13/2015
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