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FAIRVIEW HEIGHTS MEDICAL GROUP SC NPI 1609907880


NPI Information

NPI: 1609907880
Provider Name: FAIRVIEW HEIGHTS MEDICAL GROUP SC

Doing Business As: ALTON SURGERY

Classification: Surgery - 208600000X
Entity Type: Organization
Address:
2 MEMORIAL DR
SUITE 105
ALTON, IL
ZIP 62002
Phone: (618) 462-3191
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FAIRVIEW HEIGHTS MEDICAL GROUP SC is a surgery in Alton, IL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. FAIRVIEW HEIGHTS MEDICAL GROUP SC NPI is 1609907880. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Alton Surgery.

The provider's business location address is:

2 MEMORIAL DR
SUITE 105
ALTON, IL
ZIP 62002-723
Phone: (618) 462-3191

The provider's authorized official is Raymond P Davidson .
The authorized official title is President and has the following contact phone number (314) 286-2028.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 1/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1413610MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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