Organization
MEDICAL ARTS CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE W BLAISE MD (PRESIDENT)
(618) 684-2172
Entity
Organization
Contact information
Practice address
19 E SHAWNEE DR, MURPHYSBORO, IL 62966-7049
(618) 684-2172
(618) 687-4480
Mailing address
19 E SHAWNEE DR, MURPHYSBORO, IL 62966-7049
(618) 684-2172
(618) 687-4480
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/06/2006
Last updated
08/22/2020
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