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Individual

DR. LARRY F OVERCASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7309 N KNOXVILLE AVE, SUITE 300, PEORIA, IL 61614-2085
(309) 671-5100
(309) 671-5155
Mailing address
7309 N KNOXVILLE AVE, SUITE 300, PEORIA, IL 61614-2085
(309) 671-5100
(309) 671-5155

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036072608
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360726082
IL
Enumeration date
04/26/2006
Last updated
06/24/2010
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