| Crossroads Family Associates #1 | |
|
209 Crossroads Pl Suite 120 Mount Vernon IL 62864-6254 | |
| (618) 242-3119 | |
| (618) 242-3132 |
| Full Name | Crossroads Family Associates #1 |
|---|---|
| Speciality | Family Medicine |
| Location | 209 Crossroads Pl, Mount Vernon, Illinois |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Family Associates #1 209 Crossroads Pl Suite 120 Mount Vernon IL 62864-6254 Ph: (618) 242-3119 | Crossroads Family Associates #1 209 Crossroads Pl Suite 120 Mount Vernon IL 62864-6254 Ph: (618) 242-3119 |
| NPI Number | 1780678797 |
|---|---|
| Provider Enumeration Date | 09/06/2005 |
| Last Update Date | 01/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780678797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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