Organization
ASSSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Active
Parent organization
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASSOCIATED PHYSICIANS & SURGEONS CLINIC, LLC
Authorized official
MICHAEL P FOUTY (CFO/AUTHORIZED REPRESENTATIVE)
(812) 232-0564
Entity
Organization
Contact information
Practice address
410 N 2ND ST, MARSHALL, IL 62441-1010
(812) 232-0564
(812) 242-3848
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 232-0564
(812) 242-3848
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176835
US DEPT OF LABOR
—
01
—
ZD3948
OPTIMUM CHOICE INC
—
Enumeration date
10/13/2006
Last updated
11/06/2007
Update your record
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