Ridgway Family Medicine Clinic | |
113 W Main Ridgway IL 62978 | |
(618) 272-3300 | |
(618) 272-3700 |
Full Name | Ridgway Family Medicine Clinic |
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Speciality | Family Medicine |
Location | 113 W Main, Ridgway, Illinois |
Authorized Official Name and Position | Jamie Peterson (PRESIDENT) |
Authorized Official Contact | 6182732100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Ridgway Family Medicine Clinic 113 Main Street P O Box 548 Ridgway IL 62979-0548 Ph: (618) 272-3300 | Ridgway Family Medicine Clinic 113 W Main Ridgway IL 62978 Ph: (618) 272-3300 |
NPI Number | 1356535397 |
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Provider Enumeration Date | 09/04/2007 |
Last Update Date | 01/22/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356535397 | NPI | - | NPPES |
0361037154 | Medicaid | IL | |
K05588 | Other | IL | MEDICARE ID-TYPE UNSPECIF |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Primary |