Passavant Physician Association

NPI #1205387958 in Jacksonville, Illinois

Provider Information

NPI Number
1205387958
Entity Type
Organization
Organization Name
Passavant Physician Association
Subpart
Yes (part of a larger organization)
Parent Organization
PASSAVANT MEMORIAL AREA HOSPITAL
Primary Specialty
Clinic/Center - Rural Health
Enumeration Date
Oct 18, 2016
Last Updated
Oct 18, 2016

Practice Location

Address
1600 W WALNUT ST
ZIP Code
62650-1136
Phone
(217) 243-8455

Authorized Official

Name
MR. STEPHEN G LEE
Title
PRACTICE MANAGER
Phone
(217) 479-5890

Specialties & Taxonomy Codes

Specialty
Obstetrics & Gynecology
Clinic/Center - Rural HealthRural Health

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