Crossroads Physician Corp
NPI #1669466686 in Mount Vernon, Illinois
Provider Information
- NPI Number
- 1669466686
- Entity Type
- Organization
- Organization Name
- Crossroads Physician Corp
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- CROSSROADS PHYSICIAN CORP
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Sep 6, 2005
- Last Updated
- Aug 10, 2011
Practice Location
- Address
- 3505 BROADWAY ST
- City
- Mount Vernon
- State
- Illinois
- ZIP Code
- 62864-2202
- Phone
- (618) 241-8772
Authorized Official
- Name
- DEBBIE BREWER
- Title
- DIRECTOR OF PROVIDER ENROLLMENT
- Phone
- (615) 465-7626
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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