Dr Edwin Roy Mathews, DO | |
15 Founders Ln Ste 100, Jacksonville, IL 62650-3924 | |
(217) 243-0300 | |
(217) 245-6775 |
Full Name | Dr Edwin Roy Mathews |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 15 Founders Ln Ste 100, Jacksonville, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225657125 | NPI | - | NPPES |
036.165011 | Other | IL | MD LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036.165011 (Illinois) | Primary |
Entity Name | Memorial Physician Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417922964 PECOS PAC ID: 9032005681 Enrollment ID: O20040223000454 |
Mailing Address | Practice Location Address |
---|---|
Dr Edwin Roy Mathews, DO 15 Founders Ln Ste 100, Jacksonville, IL 62650-3924 Ph: (217) 243-0300 | Dr Edwin Roy Mathews, DO 15 Founders Ln Ste 100, Jacksonville, IL 62650-3924 Ph: (217) 243-0300 |
Dr. Eli G Goodman, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 W Walnut St, Jacksonville, IL 62650 Phone: 217-479-5890 | |
Dr. Babu Rao Eladasari, MD,FACP Internal Medicine Medicare: Medicare Enrolled Practice Location: 559 N Westgate Ave, Jacksonville, IL 62650 Phone: 217-243-5474 Fax: 217-245-2322 | |
Dr. Thomas Anthony Baker, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2268 E Morton Ave, Jacksonville, IL 62650 Phone: 217-245-1481 | |
Chandupatla Prabhakar, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 559 N Westgate, Jacksonville, IL 62650 Phone: 217-243-5474 Fax: 217-245-2322 | |
Dr. David D Coultas, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1606 W Lafayette Ave, Jacksonville, IL 62650 Phone: 217-245-1421 Fax: 217-243-1699 |