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1073 W Washington St Pittsfield IL 62363-1666 | |
(217) 285-9661 | |
(217) 285-4641 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 1073 W Washington St, Pittsfield, Illinois |
Authorized Official Name and Position | Ronald L Johnson (OWNER/PHYSICIAN) |
Authorized Official Contact | 2172859661 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1073 W Washington St Pittsfield IL 62363-1666 Ph: (217) 285-9661 | 1073 W Washington St Pittsfield IL 62363-1666 Ph: (217) 285-9661 |
NPI Number | 1720088776 |
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Provider Enumeration Date | 07/29/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1720088776 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 143946 (Illinois) | Primary |