| Crossroads Family Medicine Of Mt Vernon | |
|
209 Crossroads Pl Suite 120 Mount Vernon IL 62864-6545 | |
| (618) 244-6222 | |
| (618) 244-7299 |
| Full Name | Crossroads Family Medicine Of Mt Vernon |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 209 Crossroads Pl, Mount Vernon, Illinois |
| Authorized Official Name and Position | Tara P Richardson (AUTHORIZED OFFICAL) |
| Authorized Official Contact | 6152213672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Family Medicine Of Mt Vernon Po Box 689022 Franklin TN 37068-9022 Ph: (800) 709-7338 | Crossroads Family Medicine Of Mt Vernon 209 Crossroads Pl Suite 120 Mount Vernon IL 62864-6545 Ph: (618) 244-6222 |
| NPI Number | 1962753277 |
|---|---|
| Provider Enumeration Date | 09/26/2012 |
| Last Update Date | 04/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962753277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 0003947 (Illinois) | Primary |
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