ALTON SURGERY – NPI #1780740936
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

ALTON SURGERY is an AHC clinic located in ALTON, IL. NPPES has assigned the NPI number 1780740936 to ALTON SURGERY on December 29, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ALTON SURGERY” is a dba name, the actual legal business name for this organization is FAIRVIEW HEIGHTS MEDICAL GROUP SC. The primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

The NPI profile was previously updated about 18 years ago on Jan 04, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ALTON SURGERY below.

NPI Profile for
FAIRVIEW HEIGHTS MEDICAL GROUP SC

NPI Number
1780740936
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
FAIRVIEW HEIGHTS MEDICAL GROUP SC
Doing Business As (dba): ALTON SURGERY
Primary location
2 MEMORIAL DR
SUITE 105
ALTON, IL 62002-6723
Phone: (618) 462-3191 Fax:
Mailing address
670 MASON RIDGE CENTER DR
SUITE 300
SAINT LOUIS, MO 63141-8573
Phone: (314) 996-7644 Fax: (314) 966-7658
Organization Subpart
No
Authorized Official
RAYMOND DAVIDSON
PRESIDENT
Phone: (314) 286-2028
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM2500X
- Clinic/Center / Medical Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.