| |
1611 Veterans Ave Vandalia IL 62471-3303 | |
(618) 690-3597 | |
(618) 690-3598 |
Full Name | |
---|---|
Speciality | Clinic/center |
Location | 1611 Veterans Ave, Vandalia, Illinois |
Authorized Official Name and Position | Mark Duane Evard (VP OF REVENUE CYCLE) |
Authorized Official Contact | 2174929651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
3051 Hollis Dr Springfield IL 62704-7450 Ph: (217) 492-2357 | 1611 Veterans Ave Vandalia IL 62471-3303 Ph: (618) 690-3597 |
NPI Number | 1407448319 |
---|---|
Provider Enumeration Date | 02/11/2021 |
Last Update Date | 10/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407448319 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Brian W Dossett Md Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1029 N 8th St, Vandalia, IL 62471 Phone: 618-283-4469 Fax: 618-283-4794 | |
Kaskaskia Medical Center, Ltd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1003 N 8th St, Vandalia, IL 62471 Phone: 618-283-4445 Fax: 618-283-4446 | |