Organization
MARION EYE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAQBOOL AHMAD M.D. (PRESIDENT)
(618) 993-5686
Entity
Organization
Contact information
Practice address
2900 BROADWAY ST, SUITE B, MOUNT VERNON, IL 62864-2341
(618) 969-8700
(618) 899-9020
Mailing address
2900 BROADWAY ST, SUITE B, MOUNT VERNON, IL 62864-2341
(618) 969-8700
(618) 899-9020
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7003143
IL
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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