CROSSROADS PHYSICIAN CORP

MOUNT VERNON, IL
NPI1780678797
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 Date2008-01-02
Business Address
CROSSROADS PHYSICIAN CORP
209 CROSSROADS PL SUITE 120
MOUNT VERNON, IL 62864-6254
Phone number: 618-242-3119
Mailing Address
CROSSROADS PHYSICIAN CORP
209 CROSSROADS PL SUITE 120
MOUNT VERNON, IL 62864-6254
Phone number: 618-242-3119
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