| Ast Primary Care Mt Vernon | |
|
4200 Williamson Pl Ste 1a Mount Vernon IL 62864-6705 | |
| (618) 899-9195 | |
| (618) 918-7151 |
| Full Name | Ast Primary Care Mt Vernon |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 4200 Williamson Pl Ste 1a, Mount Vernon, Illinois |
| Authorized Official Name and Position | Jennia Rensing (OFFICE MANAGER) |
| Authorized Official Contact | 6188999200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ast Primary Care Mt Vernon 4200 Williamson Pl Ste 1a Mount Vernon IL 62864-6705 Ph: (618) 899-9195 | Ast Primary Care Mt Vernon 4200 Williamson Pl Ste 1a Mount Vernon IL 62864-6705 Ph: (618) 899-9195 |
| NPI Number | 1902583909 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902583909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
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