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Organization
JACKSONVILLE, LLC
Active
Organization
JACKSONVILLE, LLC
Active
Other names
Jacksonville Family Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
J. TRAVIS DOWELL (VICE PRESIDENT, HCNA AND OPERATIONS)
(217) 788-3342
Entity
Organization
Contact information
Practice address
1602 W LAFAYETTE AVE, JACKSONVILLE, IL 62650-1007
(217) 243-7200
(217) 243-6165
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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