| Crossroads Physician Corporation | |
|
205 E Belleville Okawville IL 62271 | |
| (618) 243-5151 | |
| (618) 243-5220 |
| Full Name | Crossroads Physician Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 205 E Belleville, Okawville, Illinois |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Physician Corporation 205 E Belleville Okawville IL 62271 Ph: (618) 243-5151 | Crossroads Physician Corporation 205 E Belleville Okawville IL 62271 Ph: (618) 243-5151 |
| NPI Number | 1184619033 |
|---|---|
| Provider Enumeration Date | 09/16/2005 |
| Last Update Date | 09/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184619033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
Pc Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 East Belleville Street, Okawville, IL 62271 Phone: 618-327-8119 Fax: 618-327-8141 |