Dr Mark T Donvito, MD | |
2 S Hospital Dr, Murphysboro, IL 62966-3333 | |
(618) 684-3156 | |
(618) 529-0524 |
Full Name | Dr Mark T Donvito |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 2 S Hospital Dr, Murphysboro, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073564175 | NPI | - | NPPES |
036077356-4 | Medicaid | IL | |
1073564175 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036-077356 (Illinois) | Primary |
Entity Name | Illinois Emergency Physicians Llp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861633380 PECOS PAC ID: 2365341567 Enrollment ID: O20040107000479 |
Entity Name | Southern Illinois Medical Services Nfp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
Entity Name | Pinckneyville Community Hospital |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1689646523 PECOS PAC ID: 8123921632 Enrollment ID: O20080506000051 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark T Donvito, MD 405 W Jackson St, Carbondale, IL 62901-1462 Ph: (800) 701-3381 | Dr Mark T Donvito, MD 2 S Hospital Dr, Murphysboro, IL 62966-3333 Ph: (618) 684-3156 |
Dr. Valerie Ann Kupferer, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 628 N 14th St, Murphysboro, IL 62966 Phone: 618-687-2353 Fax: 618-351-5665 | |
Dr. Gerald Wayne Mcclallen, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-684-3156 Fax: 618-529-0524 | |
Dr. Thomas William Kupferer, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 628 N 14th St, Murphysboro, IL 62966 Phone: 618-687-2353 Fax: 618-687-9511 |