Organization
MED EAST SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP H DENNIS M.D. (PRESIDENT)
(618) 874-5016
Entity
Organization
Contact information
Practice address
129 N 8TH ST, SUITE 228, EAST SAINT LOUIS, IL 62201-2917
(618) 874-5016
Mailing address
100 E VANDALIA ST, EDWARDSVILLE, IL 62025-1703
(618) 792-6496
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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