Organization
MARYVILLE MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH A. PAGE (CEO)
(866) 916-5259
Entity
Organization
Contact information
Practice address
2504 COMMERCE, HIGHLAND, IL 62249-0017
(618) 651-9777
(618) 651-3419
Mailing address
PO BOX 537, EDWARDSVILLE, IL 62025-0537
(800) 210-7034
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/12/2015
Last updated
03/20/2015
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