| Dr Mark T Donvito, MD | |
| 
					2 S Hospital Dr, Murphysboro, IL 62966-3333  | |
| (618) 684-3156 | |
| (618) 529-0524 | 
| Full Name | Dr Mark T Donvito | 
|---|---|
| Gender | Male | 
| Speciality | Emergency Medicine | 
| Location | 2 S Hospital Dr, Murphysboro, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1073564175 | NPI | - | NPPES | 
| 036077356-4 | Medicaid | IL | |
| 1073564175 | Medicaid | KY | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036-077356 (Illinois) | Primary | 
| Entity Name | Southern Illinois Medical Services Nfp | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595  | 
| Entity Name | Pinckneyville Community Hospital | 
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital | 
| Entity Identifiers | NPI Number: 1689646523 PECOS PAC ID: 8123921632 Enrollment ID: O20080506000051  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Mark T Donvito, MD 405 W Jackson St, Carbondale, IL 62901-1462 Ph: (800) 701-3381  | Dr Mark T Donvito, MD 2 S Hospital Dr, Murphysboro, IL 62966-3333 Ph: (618) 684-3156  | 
Dr. Valerie Ann Kupferer, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 628 N 14th St, Murphysboro, IL 62966 Phone: 618-687-2353 Fax: 618-351-5665  | |
Dr. Gerald Wayne Mcclallen, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2 S Hospital Dr, Murphysboro, IL 62966 Phone: 618-684-3156 Fax: 618-529-0524  | |
Dr. Thomas William Kupferer, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 628 N 14th St, Murphysboro, IL 62966 Phone: 618-687-2353 Fax: 618-687-9511  |