CROSSROADS PHYSICIAN CORP

MOUNT VERNON, IL
NPI1699769612
Doing Business AsCROSSROADS FAMILY ASSOCIATES #2
Entity TypeOrganization
Authorized ContactDEBBIE T BREWER
Director Of Provider Enrollment
615-465-7626
Organization Subpart ?Yes
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2005-09-06
Last Update Date2007-09-18
Business Address
CROSSROADS PHYSICIAN CORP
209 CROSSROADS PL SUITE 150
MOUNT VERNON, IL 62864-6254
Phone number: 618-244-6222
Mailing Address
CROSSROADS PHYSICIAN CORP
209 CROSSROADS PL SUITE 150
MOUNT VERNON, IL 62864-6254
Phone number: 618-244-6222