A Pramote Md Sc | |
404 Lincoln Drive Herrin IL 62948 | |
(618) 997-0166 | |
Not Available |
Full Name | A Pramote Md Sc |
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Speciality | Internal Medicine |
Location | 404 Lincoln Drive, Herrin, Illinois |
Authorized Official Name and Position | Pramote Anantachai (PRESIDENT CO OWNER) |
Authorized Official Contact | 6199970166 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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A Pramote Md Sc 404 Lincoln Drive Herrin IL 62948 Ph: (618) 997-0166 | A Pramote Md Sc 404 Lincoln Drive Herrin IL 62948 Ph: (618) 997-0166 |
NPI Number | 1144395633 |
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Provider Enumeration Date | 11/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144395633 | NPI | - | NPPES |
102992 | Other | FBL OWCP | |
0663336 | Other | UMWA HR FUNDS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 3650261 (Illinois) | Primary |
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