East Fork Emergency Physicians LLC

NPI #1528376647 in Olney, Illinois

Provider Information

NPI Number: 1528376647
Entity Type: Organization
Organization Name: East Fork Emergency Physicians LLC
Primary Specialty: Emergency Medicine
Enumeration Date: Sep 23, 2010
Last Updated: Feb 7, 2014

Practice Location

Address: 800 E LOCUST ST
City: Olney
State: Illinois
ZIP Code: 62450-2553
Phone: (618) 395-2131

Authorized Official

Name: JOSEPH H GATEWOOD, M.D.
Title: PRESIDENT
Phone: (469) 401-2386

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary

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