Organization
KETAN C. VYAS, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KETAN C VYAS M.D. (PRESIDENT)
(618) 375-7101
Entity
Organization
Contact information
Practice address
610 N COURT ST, GRAYVILLE, IL 62844-1002
(618) 375-7101
(618) 375-7183
Mailing address
610 N COURT ST, GRAYVILLE, IL 62844-1002
(618) 375-7101
(618) 375-7183
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036091476
IL
Other
Enumeration date
02/19/2007
Last updated
07/15/2008
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