Provider Demographics
NPI:1639461692
Name:EZDOCTORSRX.COM INC.
Entity Type:Organization
Organization Name:EZDOCTORSRX.COM INC.
Other - Org Name:EZ DOCTORS QUICK CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEEL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:812-882-2400
Mailing Address - Street 1:1621 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-4211
Mailing Address - Country:US
Mailing Address - Phone:812-882-2400
Mailing Address - Fax:812-882-2422
Practice Address - Street 1:1621 WILLOW ST
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-4211
Practice Address - Country:US
Practice Address - Phone:812-882-2400
Practice Address - Fax:812-882-2422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty