Organization
KOKE MILL MEDICAL ASSOCIATES, LLC
Active
Organization
KOKE MILL MEDICAL 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
3132 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7400
(217) 862-0800
(217) 862-0871
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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