Organization
MARYVILLE PHYSICIANS SERVICES INC
Active
Parent organization
MARYVILLE PHYSICIANS SERVICES INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARYVILLE PHYSICIANS SERVICES INC
Authorized official
KEITH PAGE (PRESIDENT)
(618) 288-5711
Entity
Organization
Contact information
Practice address
6812 STATE ROUTE 162, SUITE 123, MARYVILLE, IL 62062-8553
(618) 288-9460
(618) 288-9461
Mailing address
1836 LACKLAND HILL PKWY, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
04/20/2009
Last updated
02/12/2010
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