St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order in Springfield - Physician Assistant
St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order - NPI 1174702708
St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order is a Physician Assistant in Springfield, Illinois. St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order is 1174702708. The last update date is 2023-09-19.
St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order's current location address is 3051 Hollis Dr, Springfield, Illinois. You can contact this provider via phone number 2174642966 and fax number 2174641039. The mailing address for St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order is 3051 Hollis Dr, Springfield, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order |
|---|---|
| Address | 3051 Hollis Dr, Springfield, Illinois |
| Phone Number | 2174642966 |
| Fax Number | 2174641039 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | VP OF REVE |
|---|---|
| Authorized Official Name | Evard D Mark |
| Telephone Number | 2174929651 |
NPI Number Detail
| NPI Number | 1174702708 |
|---|---|
| Provider Enumeration Date | 2007-10-31 |
| Last Updated Date | 2023-09-19 |
Provider Mailing Address Detail
| Address | 3051 Hollis Dr |
|---|---|
| City | Springfield |
| State | Illinois (IL) |
| Post Code | 627047450 |
| Phone Number | 2174642966 |
| Fax Number | 2174641039 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 085-003034 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order's unique identification number?
The St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order has been assigned the NPI (National Provider Identifier) Number 1174702708 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete physical location address of St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order?
The St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order is physically situated at 3051 Hollis Dr, in the city of Springfield, state of IL, with the postal code 627047450.
What is the St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order's specialty and taxonomy code?
The St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1174702708 to St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order?
The St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order received its 1174702708 assignment from the Centers for Medicare & Medicaid Services on 2007-10-31.
As of what date were the details related to St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order most recently updated or revised?
The information pertaining to St. Marys Hospital Decatur Of The Hospital Sisters Of The Third Order, including its address, specialty, and other relevant details, was last updated or revised on 2023-09-19.
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