| J C Purnell Md Sc | |
|
401 E Water Street Pontiac IL 61764-0470 | |
| (815) 842-1166 | |
| (815) 844-5968 |
| Full Name | J C Purnell Md Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 401 E Water Street, Pontiac, Illinois |
| Authorized Official Name and Position | John C Purnell (OWNER) |
| Authorized Official Contact | 8158421166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J C Purnell Md Sc Po Box 470 Pontiac IL 61764-0470 Ph: (815) 842-1166 | J C Purnell Md Sc 401 E Water Street Pontiac IL 61764-0470 Ph: (815) 842-1166 |
| NPI Number | 1457426363 |
|---|---|
| Provider Enumeration Date | 11/24/2006 |
| Last Update Date | 10/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457426363 | NPI | - | NPPES |
| 05300058 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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