Southern Illinois Surgical Associates, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

SOUTHERN ILLINOIS SURGICAL ASSOCIATES, PC

Practice address

8333 Express Dr Ste D
Marion, IL 62959-6474

Phone

(618) 997-3103

Fax

(618) 997-3241

NPI assigned

Oct 16, 2007

Last updated

Oct 16, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rodney Lee Miller, MDNPI 1750382396

Title

President

Phone

(618) 997-3103

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rodney Lee Miller, MD

  • Surgery Physician
  • Herrin, IL
  • NPI 1750382396
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1184813115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 EXPRESS DR STE D",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596474",
            "telephone_number": "618-997-3103",
            "fax_number": "618-997-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 EXPRESS DR STE D",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629596474",
            "telephone_number": "618-997-3103",
            "fax_number": "618-997-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ILLINOIS SURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-997-3103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP ID NUMBER",
            "identifier": "208971",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Illinois Oncology & Hematology LTD
• Southern Illinois Pain Management
• Southern Illinois Psychiatry LLC
• Southern Illinois Sleep Institute
• Southern Illinois Surgical Appliance Company
• Southern Illinois Urology
• Southern Illinois Vein Center, LLC
• Southern Spine & Rehab, PLLC
• Amanda Sowers
• Marsha A. Sparks

• Surgery Physician in Marion, IL
• Providers in Marion, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.