Individual
GREGORY SCOTT CHURCHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
310 N 7 HILLS RD, O FALLON, IL 62269-4111
(618) 624-6181
(618) 624-7172
Mailing address
409 SHILOH STATION RD, O FALLON, IL 62269-4000
(618) 624-7383
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085002702
IL
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/16/2006
Last updated
03/25/2021
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