Organization
SOUTHERN ILLINOIS SURGICAL ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY LEE MILLER MD (PRESIDENT)
(618) 997-3103
Entity
Organization
Contact information
Practice address
8333 EXPRESS DR STE D, MARION, IL 62959-6474
(618) 997-3103
(618) 997-3241
Mailing address
8333 EXPRESS DR STE D, MARION, IL 62959-6474
(618) 997-3103
(618) 997-3241
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208971
GROUP ID NUMBER
IL
Enumeration date
10/16/2007
Last updated
10/16/2007
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