Organization
ENT-HEAD & NECK & FACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT RICHARD GOLDBURG M.D. (PRESIDENT)
(765) 671-7741
Entity
Organization
Contact information
Practice address
1391 N BALDWIN AVE, MARION, IN 46952-1913
(765) 671-7741
(765) 651-4272
Mailing address
1391 N BALDWIN AVE, MARION, IN 46952-1913
(765) 671-7741
(765) 651-4272
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
01/24/2007
Last updated
02/26/2008
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