Forrest Family Practice Center LLC

NPI #1104003086 in Forrest, Illinois

Provider Information

NPI Number: 1104003086
Entity Type: Organization
Organization Name: Forrest Family Practice Center LLC
Subpart: Yes (part of a larger organization)
Parent Organization: GIBSON COMMUNITY HOSPITAL ASSOCIATION
Primary Specialty: Family Medicine
Enumeration Date: Jan 23, 2008
Last Updated: Jul 2, 2009

Practice Location

Address: 122 E WABASH AVE
City: Forrest
State: Illinois
ZIP Code: 61741
Phone: (815) 657-8707

Authorized Official

Name: DR. BENJAMIN E BREWER, MD
Title: OWNER
Phone: (815) 657-8707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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