Organization
MURPHYSBORO INTERNAL MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANTE T TRINH M.D. (PRESIDENT)
(618) 684-6408
Entity
Organization
Contact information
Practice address
1032 N 6TH ST, MURPHYSBORO, IL 62966-2267
(618) 684-6408
(618) 684-3637
Mailing address
1032 N 6TH ST, MURPHYSBORO, IL 62966-2267
(618) 684-6408
(618) 684-3637
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036110916
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110916
—
IL
01
—
03932025
BC BS IL
IL
Enumeration date
10/02/2007
Last updated
09/19/2008
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