Organization
SOUTHERN ILLINOIS OTOLARYNGOLOGY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY CURTIS DOBBS M.D. (PRESIDENT)
(618) 235-8082
Entity
Organization
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 930, BELLEVILLE, IL 62223-5000
(618) 235-8082
(618) 235-7955
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 930, BELLEVILLE, IL 62223-5000
(618) 235-8082
(618) 235-7795
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
647890
MEDICARE PTAN
IL
Enumeration date
11/19/2007
Last updated
01/07/2008
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