Alt, Suzanne E
Alt, Suzanne E is an individual health care provider with primary practice located at 4230 Lincolnshire Dr Ste G , Mount Vernon IL 62864-2189. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Alt, Suzanne E can be contacted via phone (618) 244-6770.Contact Information
Primary practice address
4230 Lincolnshire Dr Ste G
Mount Vernon IL 62864-2189
Phone: (618) 244-6770
Fax: (618) 244-6772
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | R9G62 | Missouri |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | R9G62 | Missouri |
Profile Details
| NPI number | 1811995566 |
|---|---|
| LBN Legal business name | Alt, Suzanne E |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2005 |
| Last updated | Sep 29th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811995566 | NPPES |
| Missouri | Other | 173297 | BLUE SHIELD MO |
| Missouri | MEDICAID | 243396934 | BLUE SHIELD MO |
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