Organization
BARD AND DIDRIKSEN PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE MARIE SUDHOLT (OFFICE MANAGER)
(618) 692-1212
Entity
Organization
Contact information
Practice address
2160 SO IL RT 157, SUITE B, GLEN CARBON, IL 62034
(618) 692-1212
(618) 692-4875
Mailing address
2160 SO. IL. RT. 157, SUITE B, GLEN CARBON, IL 62034
(618) 692-1212
(618) 692-4875
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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