Crossroads Physician Corporation

NPI #1629063698 in Nashville, Illinois

Provider Information

NPI Number: 1629063698
Entity Type: Organization
Organization Name: Crossroads Physician Corporation
Primary Specialty: Family Medicine
Enumeration Date: Sep 15, 2005
Last Updated: Apr 27, 2009

Practice Location

Address: 1245 S MILL ST
City: Nashville
State: Illinois
ZIP Code: 62263-2004
Phone: (618) 327-9333

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X
Family Medicine	207Q00000X	Primary

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