Organization
CROSSROADS PHYSICIAN CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR)
(615) 465-7626
Entity
Organization
Contact information
Practice address
209 CROSSROADS PL, SUITE 140, MOUNT VERNON, IL 62864-6545
(618) 241-7207
(618) 241-7210
Mailing address
209 CROSSRODS PL, SUITE 140, MOUNT VERNON, IL 62864-6545
(618) 241-7207
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
207R00000X
Internal Medicine Physician
—
IL
363L00000X
Nurse Practitioner
—
IL
Other
Enumeration date
07/24/2008
Last updated
07/28/2008
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