Organization
DEEPTHI S SAXENA MD PC
Active
Other names
AVANT-GARDE MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEEPTHI S CULL M.D. (PRESIDENT)
(847) 767-0137
Entity
Organization
Contact information
Practice address
9355 WARRICK WELLNESS TRL, NEWBURGH, IN 47630-0015
(812) 476-9983
Mailing address
4225 LINCOLNSHIRE DR STE B, MOUNT VERNON, IL 62864-2157
(618) 242-2317
(618) 242-9710
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
12455
NV
Other
Enumeration date
04/07/2011
Last updated
07/20/2020
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