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Organization
PHYSICIAN RURAL HEALTH CLINIC OF JEFFERSON COUNTY
Active
Organization
PHYSICIAN RURAL HEALTH CLINIC OF JEFFERSON COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VEENA K GUPTA M.D. (CEO)
(618) 244-7200
Entity
Organization
Contact information
Practice address
3307 BROADWAY ST, STE 130, MOUNT VERNON, IL 62864-2347
(618) 244-2560
(618) 244-1572
Mailing address
3307 BROADWAY ST, STE 130, MOUNT VERNON, IL 62864-2347
(618) 244-2560
(618) 244-1572
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/15/2006
Last updated
10/15/2008
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