Organization
GADSON CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL THOMAS GADSON MD (OWNER)
(217) 223-7911
Entity
Organization
Contact information
Practice address
1622 BROADWAY ST, QUINCY, IL 62301-2817
(217) 223-7911
(217) 223-7941
Mailing address
1622 BROADWAY ST, QUINCY, IL 62301-2817
(217) 223-7911
(217) 223-7941
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018853
HEALTH ALLIANCE
IL
01
—
076559
QHCM
IL
01
—
120152
BLUE CROSS BLUE SHIELD
IL
01
—
138989
HELATHLINK
IL
01
—
16189
BLUE CROSS OF MISSOURI
MO
Enumeration date
11/02/2005
Last updated
08/22/2020
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