Organization
FAIRVIEW HEIGHTS MEDICAL GROUP SC
Active
Other names
Alton Urology - Glen Carbon
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND P DAVIDSON II MD (PRESIDENT)
(314) 286-2028
Entity
Organization
Contact information
Practice address
2246 S STATE ROUTE 157, STE. 200, GLEN CARBON, IL 62034-1717
(618) 288-5888
(618) 288-6475
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7644
(314) 996-7658
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
11/27/2007
Last updated
01/07/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up