Organization
MARION EYE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAQBOOL AHMAD M.D. (PRESIDENT)
(618) 993-5686
Entity
Organization
Contact information
Practice address
2900 BROADWAY ST, STE. B, MOUNT VERNON, IL 62864-2341
(618) 969-8700
(618) 899-9020
Mailing address
PO BOX 1178, MARION, IL 62959-7678
(618) 969-8777
(618) 997-6250
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7003143
IL
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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