Physician Management Services of Southern Illinois, LLC

NPI #1306355037 in Marion, Illinois

Provider Information

NPI Number: 1306355037
Entity Type: Organization
Organization Name: Physician Management Services of Southern Illinois, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: VAXCARE CORPORATION
Primary Specialty: Family Medicine
Enumeration Date: Sep 26, 2017
Last Updated: Sep 26, 2017

Practice Location

Address: 3412 OFFICE PARK DR
City: Marion
State: Illinois
ZIP Code: 62959-6477
Phone: (888) 829-8550

Authorized Official

Name: BRETT KENEFICK
Title: PRESIDENT
Phone: (888) 829-8550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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