Organization
MENARD MEDICAL CENTER, 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
1 CENTRE DR, PETERSBURG, IL 62675-9467
(217) 632-7761
(217) 632-0312
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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