CROSSROADS PHYSICIAN CORP

MOUNT VERNON, IL
NPI1790779874
Doing Business AsCROSSROADS INTERNAL MEDICINE #1
Entity TypeOrganization
Authorized ContactDEBBIE T BREWER
Director Of Provider Enrollment
615-465-7626
Organization Subpart ?Yes
Primary Taxonomy207R00000X Internal Medicine
Additional Taxonomies363L00000X Nurse Practitioner
Enumeration Date2005-09-06
Last Update Date2007-10-30
Business Address
CROSSROADS PHYSICIAN CORP
4101 N WATER TOWER PL
MOUNT VERNON, IL 62864-6296
Phone number: 618-244-4313
Mailing Address
CROSSROADS PHYSICIAN CORP
4101 N WATER TOWER PL
MOUNT VERNON, IL 62864-6296
Phone number: 618-244-4313