| Dr Gregg E Davis, MD | |
|
204 Park Ave E, Princeton, IL 61356-2114 | |
| (815) 879-3212 | |
| (815) 879-8602 |
| Full Name | Dr Gregg E Davis |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 204 Park Ave E, Princeton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306887674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 36058885 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 036-058885 (Illinois) | Primary |
| Entity Name | Community Health Partnership Of Illinois |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932375169 PECOS PAC ID: 6901053511 Enrollment ID: O20130723000458 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gregg E Davis, MD 204 Park Ave E, Princeton, IL 61356-2114 Ph: (815) 879-3212 | Dr Gregg E Davis, MD 204 Park Ave E, Princeton, IL 61356-2114 Ph: (815) 879-3212 |
Christopher Thomas Blanford, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 535 Park Ave E, Princeton, IL 61356 Phone: 815-875-4531 Fax: 815-876-2118 | |
Manuel R Ascano Sr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 535 Park Ave E, Princeton, IL 61356 Phone: 815-875-4531 Fax: 815-876-2118 | |
Robert E Mestan, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 535 Park Ave E, Princeton, IL 61356 Phone: 815-875-4531 | |
Miss Robin L Rose, APRN, FNP-BC Family Medicine Medicare: Medicare Enrolled Practice Location: 535 Park Ave E, Princeton, IL 61356 Phone: 815-875-4531 |