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General NPI Number Information
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NPI Number | 1285650838
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Entity Type | Organization
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Legal Business Name | JACQUES PAPAZIAN M.D,S.C.
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 4117 S WATER TOWER PL SUITE C
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6293
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Country | US
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Telephone | 618-242-0672
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Fax | 618-242-0862
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Provider Business Mailing Address
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Address Line | 4117 S WATER TOWER PL SUITE C
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6567
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Country | US
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Telephone | 618-242-0672
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Fax | 618-242-0862
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Authorized Official
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Title or Position | M.D.
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Name | JACQUES PAPAZIAN
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Credential | M.D.
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Telephone | 618-242-0672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 036093598
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License Number State | IL
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