Active NPI
Southern Illinois Otolaryngology, LTD
- Otolaryngology Physician
- Belleville, IL
National Provider Identifier
1104007111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- Legal business name
- SOUTHERN ILLINOIS OTOLARYNGOLOGY, LTD
- Practice address
- 2900 Frank Scott Pkwy W
Suite 930
Belleville, IL 62223-5000 - Phone
- (618) 235-8082
- Fax
- (618) 235-7955
- NPI assigned
- Nov 19, 2007
- Last updated
- Jan 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Larry Curtis Dobbs, M.D.
- Title
- President
- Phone
- (618) 235-8082
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | Primary |
Addresses
Primary practice location
2900 Frank Scott Pkwy W
Suite 930
Belleville, IL 62223-5000
Mailing address
2900 Frank Scott Pkwy W
Suite 930
Belleville, IL 62223-5000
Phone (618) 235-8082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 647890 | Other | IL | MEDICARE PTAN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199664000000",
"number": "1104007111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W",
"address_2": "SUITE 930",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000",
"telephone_number": "618-235-8082",
"fax_number": "618-235-7795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 FRANK SCOTT PKWY W",
"address_2": "SUITE 930",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622235000",
"telephone_number": "618-235-8082",
"fax_number": "618-235-7955"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN ILLINOIS OTOLARYNGOLOGY, LTD",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-19",
"last_updated": "2008-01-07",
"status": "A",
"authorized_official_last_name": "DOBBS",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "CURTIS",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "618-235-8082",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "647890",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
- Southern Illinois Healthcare Foundation, Inc. (SIHF Healthcare)
- Southern Illinois Healthcare Foundation, Inc. (Children's Medical Center)
- Southern Illinois Internal Medicine LTD
- Southern Illinois Neurologic Institute
- Southern Illinois Oral & Maxillofacial Surgery, LTD.
- Southern Illinois Physician Services, PC
- Southern Illinois Pulmonary Consultants, LTD.
- Southern Illinois Surgical Appliance Co (Sisa Home Medical)
- Southern Illinois Vascular Surgery, PC
- Southwestern Illinois College (Alternative Transportation System)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.