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General NPI Number Information
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NPI Number | 1659354678
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Entity Type | Organization
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Legal Business Name | EDWARD J HARROW PTR, ALTON PATHOLOGY ASSOCIATES
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1 MEMORIAL DR
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City | ALTON
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State | IL
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Zip | 62002-6722
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Country | US
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Telephone | 618-463-7410
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Fax | 618-463-7641
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Provider Business Mailing Address
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Address Line | PO BOX 952009
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City | SAINT LOUIS
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State | MO
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Zip | 63195-2009
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Country | US
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Telephone | 314-821-8055
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Fax | 314-821-1833
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Authorized Official
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Title or Position | M.D.
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Name | EDWARD J HARROW
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Credential |
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Telephone | 618-463-7410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036055965
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License Number State | IL
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