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Individual

DR. JOHN T. GIRARDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 S HOSPITAL DR, MURPHYSBORO, IL 62966
(618) 684-3156
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036083489
IL
207R00000X
Internal Medicine Physician
0360834891
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360834891
IL
01
21621833
BLUECROSS AND BLUESHIELD
IL
Enumeration date
07/14/2005
Last updated
09/15/2021
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