Passavant Physician Association
NPI #1972054609 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1972054609
- 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
- Apr 4, 2017
Practice Location
- Address
- 559 N WESTGATE AVE
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1156
- Phone
- (217) 243-5474
Authorized Official
- Name
- MR. ROBERT ELLISON
- Title
- DIRECTOR
- Phone
- (217) 479-5890
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
| Internal Medicine |
| Otolaryngology |
| Clinic/Center - Rural Health — Rural Health |
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