Organization
REGIONAL ORTHOPAEDICS & SPORTS MEDICINE CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARR W LEUTZ M.D. (PRESIDENT)
(217) 243-0033
Entity
Organization
Contact information
Practice address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 243-0033
(217) 245-1791
Mailing address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 243-0033
(217) 245-1791
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036088511
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088511
—
IL
Enumeration date
03/19/2007
Last updated
07/10/2008
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