| The Country Doctor, Ltd. | |
|
2310 Country Rd Belleville IL 62221-2570 | |
| (618) 277-3197 | |
| Not Available |
| Full Name | The Country Doctor, Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 2310 Country Rd, Belleville, Illinois |
| Authorized Official Name and Position | David Larry Mitchell (PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 6182773197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Country Doctor, Ltd. 2310 Country Rd Belleville IL 62221-2570 Ph: (618) 277-3197 | The Country Doctor, Ltd. 2310 Country Rd Belleville IL 62221-2570 Ph: (618) 277-3197 |
| NPI Number | 1750553749 |
|---|---|
| Provider Enumeration Date | 03/31/2008 |
| Last Update Date | 03/31/2008 |
| Medicare PECOS PAC ID | 6002932969 |
|---|---|
| Medicare Enrollment ID | O20100928001259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750553749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | David Larry Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497759757 PECOS PAC ID: 2567588445 Enrollment ID: I20100928001503 |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Ste 160, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 | |
Pc Associates ,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Drive, Ste. 220, Belleville, IL 62226 Phone: 618-235-6191 Fax: 618-235-6716 | |
Healthcare Physicians Of Southern Illinois, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Suite 100, Belleville, IL 62226 Phone: 618-222-9999 Fax: 618-222-9337 | |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr Ste 400, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Albarcha Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 Fax: 618-355-9972 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 N 27th St, Belleville, IL 62226 Phone: 618-235-6600 |