Crossroads Physicians Corp

NPI #1144286717 in Benton, Illinois

Provider Information

NPI Number: 1144286717
Entity Type: Organization
Organization Name: Crossroads Physicians Corp
Subpart: Yes (part of a larger organization)
Parent Organization: CROSSROADS PHYSICIANS CORP
Primary Specialty: Family Medicine
Enumeration Date: Apr 24, 2006
Last Updated: Jan 2, 2008

Practice Location

Address: 203 BAILEY LN
City: Benton
State: Illinois
ZIP Code: 62812-1969
Phone: (618) 438-3621

Authorized Official

Name: DEBBIE T BREWER
Title: DIRECTOR OF PROVIDER ENROLLMENT
Phone: (615) 465-7626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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