# JOHNSTON CITY MEDICAL CLINIC, S. C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962428516
- **Authorized official:** DR. KHALID JAVED M.D. (ADMINISTRATOR)
- **Authorized official phone:** (618) 983-6911

## Contact information

- **Practice address:** 201 W BROADWAY BLVD, JOHNSTON CITY, IL 62951-1427
- **Practice address phone:** (618) 983-6911
- **Practice address fax:** (618) 983-6913
- **Mailing address:** 201 W BROADWAY BLVD, P. O. BOX 209, JOHNSTON CITY, IL 62951-1427
- **Mailing address phone:** (618) 983-6911
- **Mailing address fax:** (618) 983-6913

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 07/15/2006
- **Last updated:** 08/22/2020