Organization
NEW CENTURY PHYSICIANS OF SOUTHERN ILLINOIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM A COLE JR. MD (CEO)
(800) 726-3627
Entity
Organization
Contact information
Practice address
3333 W DEYOUNG ST, MARION, IL 62959-5884
(618) 998-7000
(618) 997-6589
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1443332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10032029
BC/BS GRP PROVIDER #
IL
01
—
610626900
FEDERAL BLACK LUNG
IL
Enumeration date
07/15/2005
Last updated
10/29/2008
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