| Goreville Family Practice | |
|
200 S Broadway Goreville IL 62939-2447 | |
| (618) 995-2396 | |
| (618) 995-2947 |
| Full Name | Goreville Family Practice |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 200 S Broadway, Goreville, Illinois |
| Authorized Official Name and Position | Crystal L Stangle (OWNER CEO) |
| Authorized Official Contact | 6189952396 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goreville Family Practice Po Box 40 200 South Broadway Street Goreville IL 62939-0040 Ph: (618) 995-2396 | Goreville Family Practice 200 S Broadway Goreville IL 62939-2447 Ph: (618) 995-2396 |
| NPI Number | 1790980985 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790980985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Rural Health, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 N Broadway, Goreville, IL 62939 Phone: 618-995-1002 Fax: 618-995-1133 | |
Goreville Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 S Broadway, Goreville, IL 62939 Phone: 618-995-1002 Fax: 618-995-1133 |