Organization
MIDWEST EMERGENCY GOOD SAMARITAN
Active
Organization
MIDWEST EMERGENCY GOOD SAMARITAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM W CRUZEN DO (OWNER/PRESIDENT)
(817) 451-4208
Entity
Organization
Contact information
Practice address
1 GOOD SAMARITAN WAY, MOUNT VERNON, IL 62864-2402
(817) 451-4208
(817) 563-3699
Mailing address
PO BOX 8974, FORT WORTH, TX 76124-0974
(817) 451-4208
(817) 563-3699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036061115
IL
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
Update your record
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