| Kirby Medical Center | |
|
407 South Jackson Street Suite A Cerro Gordo IL 61818-4356 | |
| (217) 763-6010 | |
| (217) 763-6012 |
| Full Name | Kirby Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 407 South Jackson Street, Cerro Gordo, Illinois |
| Authorized Official Name and Position | Steven D Tenhouse (CEO) |
| Authorized Official Contact | 2177621501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kirby Medical Center 1000 Medical Center Dr Monticello IL 61856-2116 Ph: (217) 762-1540 | Kirby Medical Center 407 South Jackson Street Suite A Cerro Gordo IL 61818-4356 Ph: (217) 763-6010 |
| NPI Number | 1508219288 |
|---|---|
| Provider Enumeration Date | 07/19/2016 |
| Last Update Date | 12/11/2020 |
| Medicare PECOS PAC ID | 6901791144 |
|---|---|
| Medicare Enrollment ID | O20171226001002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508219288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
William H Shackelford Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 208 S Jackson St, Cerro Gordo, IL 62501 Phone: 217-763-5851 Fax: 217-763-2201 |