Organization
ADVANCED SURGICAL TECHNOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA L ADAMS (OFFICE ADMINISTRATOR)
(618) 969-8317
Entity
Organization
Contact information
Practice address
4200 WILLIAMSON PL STE 1A, MOUNT VERNON, IL 62864-6705
(618) 899-9200
(618) 899-9206
Mailing address
4200 WILLIAMSON PL STE 1A, MOUNT VERNON, IL 62864-6705
(618) 899-9200
(618) 899-9206
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036115674
IL
Other
Enumeration date
10/10/2014
Last updated
07/17/2019
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