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400 Maple Summit Rd Jerseyville IL 62052-2028 | |
| (618) 498-6402 | |
| (618) 498-8492 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 400 Maple Summit Rd, Jerseyville, Illinois |
| Authorized Official Name and Position | Beth King (CEO) |
| Authorized Official Contact | 6184988350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
400 Maple Summit Rd Jerseyville IL 62052-2028 Ph: (618) 498-6402 | 400 Maple Summit Rd Jerseyville IL 62052-2028 Ph: (618) 498-6402 |
| NPI Number | 1134163827 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 07/08/2024 |
| Certification Date | 07/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134163827 | NPI | - | NPPES |
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