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Organization

SURGICAL CLINICS LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK E DAVIS MD (PRESIDENT)
(309) 343-7773
Entity
Organization

Contact information

Practice address
834 N SEMINARY ST, SUITE 503, GALESBURG, IL 61401-2852
(309) 343-7773
(309) 343-3839
Mailing address
834 N SEMINARY ST, SUITE 503, GALESBURG, IL 61401-2852

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
344670
MEDICARE ID NUMBER
Enumeration date
07/18/2006
Last updated
03/04/2008
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