Organization Name: | DOCS TO GO |
NPI Number: | 1013178847 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | M C HEARON (PRESIDENT) |
Mailing Address: | 2241 207th Pl Lynwood |
State: | IL US |
Postal Code: | 604111538 |
Phone Number: | 6307884527 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2008 |
NPI Last Update Date: | 06/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |