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Organization
CROSSROADS PHYSICIAN CORPORATION
Active
Organization
CROSSROADS PHYSICIAN CORPORATION
Active
Parent organization
CROSSROADS PHYSICIAN CORPORATION
Other names
Crossroads Family Medicine of Okawville
Organization subpart
Yes
Provider details
NPI number
Legal business name
CROSSROADS PHYSICIAN CORPORATION
Authorized official
DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
205 E BELLEVILLE, OKAWVILLE, IL 62271
(618) 243-5151
(618) 243-5220
Mailing address
205 E BELLEVILLE, OKAWVILLE, IL 62271
(618) 243-5151
(618) 243-5220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Enumeration date
09/16/2005
Last updated
09/19/2007
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