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General NPI Number Information
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NPI Number | 1811940893
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Entity Type | Organization
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Legal Business Name | ASSOCIATED PHYSICIANS GROUP, LTD
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 916 TALON DR SUITE 102
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City | O FALLON
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State | IL
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Zip | 62269-1848
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Country | US
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Telephone | 618-628-8211
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Fax | 618-682-0883
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Provider Business Mailing Address
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Address Line | 916 TALON DR SUITE 102
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City | O FALLON
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State | IL
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Zip | 62269-1848
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Country | US
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Telephone | 618-628-8211
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Fax | 618-682-0883
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Authorized Official
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Title or Position | BILLING SUPERVISOR
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Name | MS. RENEE L CARSON
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Credential |
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Telephone | 618-628-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 042007668
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License Number State | IL
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