Organization
GIBSON CITY CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HAGAN M.D. (PRESIDENT)
(217) 784-8148
Entity
Organization
Contact information
Practice address
222 N SANGAMON AVE, GIBSON CITY, IL 60936-1345
(217) 784-8148
(217) 784-8160
Mailing address
222 N SANGAMON AVE, GIBSON CITY, IL 60936-1345
(217) 784-8148
(217) 784-8160
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036-066538
IL
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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