Healthcare Provider Details

I. General information

NPI: 1336456367
Provider Name (Legal Business Name): ARTURO GARZA-CAVAZOS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N 9TH ST SUITE 6W100
SPRINGFIELD IL
62702-5303
US

IV. Provider business mailing address

PO BOX 19640
SPRINGFIELD IL
62794-9640
US

V. Phone/Fax

Practice location:
  • Phone: 217-545-5117
  • Fax: 217-545-7958
Mailing address:
  • Phone: 217-545-5117
  • Fax: 217-545-7958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-126538
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: