Douglas C Brown, DO | |
1506 N.sioux Dr, Marion, IL 62959-5209 | |
(618) 519-9200 | |
(618) 985-9155 |
Full Name | Douglas C Brown |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 1506 N.sioux Dr, Marion, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033364674 | NPI | - | NPPES |
036120519 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036120519 (Illinois) | Primary |
Entity Name | Southern Illinois Gi Specialists Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093775405 PECOS PAC ID: 1658337456 Enrollment ID: O20041203000280 |
Mailing Address | Practice Location Address |
---|---|
Douglas C Brown, DO 109 California St, Po Box 577, Carterville, IL 61918-0577 Ph: (618) 519-9200 | Douglas C Brown, DO 1506 N.sioux Dr, Marion, IL 62959-5209 Ph: (618) 519-9200 |
Robert Joseph Tiffin Jr., MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St, Veterans Admin Hosp, Marion, IL 62959 Phone: 618-998-5617 Fax: 618-998-5697 | |
Dr. Casie E Mosley, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311 | |
Dr. Meshach Vedanayagam Samuel, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311 | |
Christopher Glazik Jr., FNP-BC Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2401 W Main St, Marion, IL 62959 Phone: 618-997-5311 | |
Dr. Renato Ralota Katubig, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1008 West Cherry Street, Suite B, Marion, IL 62959 Phone: 618-993-0404 Fax: 618-993-1717 | |
Shobha Dayal, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2401 W Main St Dept Of, Marion, IL 62959 Phone: 618-997-5311 |