Organization
SOUTHERN OBSTETRIC & GYNECO ASSOCIATES
Active
Other names
Southern OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNE E DOLL-POLLARD M.D. (PRESIDENT)
(618) 526-2209
Entity
Organization
Contact information
Practice address
1201 RICKER RD, SALEM, IL 62881-4263
(618) 526-2209
(618) 526-7372
Mailing address
9447 HOLY CROSS LN, BREESE, IL 62230-3510
(618) 526-2209
(618) 526-7372
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
042005236
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042005236
COPORATE LICENSE
IL
Enumeration date
07/03/2012
Last updated
07/03/2012
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