Organization
SURGICAL ASSOCIATES OF MT VERNON, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE SHORES M.D. (PHYSICIAN/OWNER)
(618) 899-3980
Entity
Organization
Contact information
Practice address
2 GOOD SAMARITAN WAY, SUITE 235, MOUNT VERNON, IL 62864
(618) 899-3980
(618) 899-4793
Mailing address
2 GOOD SAMARITAN WAY, SUITE 235, MOUNT VERNON, IL 62864
(618) 899-3980
(618) 899-4793
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
02/12/2007
Last updated
01/24/2014
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