Organization
MIDWEST EMERGENCY GOOD SAMARITAN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM W CRUZEN DO (PRESIDENT)
(817) 451-4208
Entity
Organization
Contact information
Practice address
605 N 12TH ST, MOUNT VERNON, IL 62864-2857
(817) 451-4208
(817) 563-3699
Mailing address
6451 BRENTWOOD STAIR ROAD, SUITE 202, FORT WORTH, TX 76112-3200
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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