| Physician Rural Health Clinic Of Jefferson County | |
|
3307 Broadway St Ste 130 Mount Vernon IL 62864-2347 | |
| (618) 244-2560 | |
| (618) 244-1572 |
| Full Name | Physician Rural Health Clinic Of Jefferson County |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 3307 Broadway St, Mount Vernon, Illinois |
| Authorized Official Name and Position | Veena K Gupta (CEO) |
| Authorized Official Contact | 6182447200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physician Rural Health Clinic Of Jefferson County 3307 Broadway St Ste 130 Mount Vernon IL 62864-2347 Ph: (618) 244-2560 | Physician Rural Health Clinic Of Jefferson County 3307 Broadway St Ste 130 Mount Vernon IL 62864-2347 Ph: (618) 244-2560 |
| NPI Number | 1649283870 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 10/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649283870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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