Organization
MED CONTRACT, INC.
Active
Other names
Ridgway Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMIE PETERSON (PRESIDENT)
(618) 273-2100
Entity
Organization
Contact information
Practice address
113 W MAIN, RIDGWAY, IL 62978
(618) 272-3300
(618) 272-3700
Mailing address
113 MAIN STREET, P O BOX 548, RIDGWAY, IL 62979-0548
(618) 272-3300
(618) 272-3700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361037154
—
IL
01
—
K05588
MEDICARE ID-TYPE UNSPECIF
IL
Enumeration date
09/04/2007
Last updated
01/22/2008
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