Organization
MIDWEST EMERGENCY SPARTA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM W CRUZEN MD (OWNER/PRESIDENT)
(817) 451-4208
Entity
Organization
Contact information
Practice address
818 E BROADWAY ST, SPARTA, IL 62286-1820
(817) 451-4208
(817) 563-3699
Mailing address
PO BOX 8174, FORT WORTH, TX 76124-0174
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
05/29/2013
Last updated
05/29/2013
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