| Crossroads Physician Corp | |
|
209 Crossroads Pl Suite 140 Mount Vernon IL 62864-6545 | |
| (618) 241-7207 | |
| (618) 241-7210 |
| Full Name | Crossroads Physician Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 209 Crossroads Pl, Mount Vernon, Illinois |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR) |
| Authorized Official Contact | 6154657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Physician Corp 209 Crossrods Pl Suite 140 Mount Vernon IL 62864-6545 Ph: (618) 241-7207 | Crossroads Physician Corp 209 Crossroads Pl Suite 140 Mount Vernon IL 62864-6545 Ph: (618) 241-7207 |
| NPI Number | 1194980516 |
|---|---|
| Provider Enumeration Date | 07/24/2008 |
| Last Update Date | 07/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194980516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| 207R00000X | Internal Medicine | (Illinois) | Secondary |
| 363L00000X | Nurse Practitioner | (Illinois) | Secondary |
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