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Organization
JACKSONVILLE PEDIATRIC ASSOCIATES, LLC
Active
Organization
JACKSONVILLE PEDIATRIC ASSOCIATES, LLC
Active
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
1600 W WALNUT ST, EAST WING, 3RD FLOOR, JACKSONVILLE, IL 62650-1136
(217) 245-5437
(217) 243-3113
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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