Organization
MACOUPIN FAMILY PRACTICE CENTERS, LLP
Active
Other names
Carlinville Family Practice Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L QUARTON (DIRECTOR)
(217) 839-4491
Entity
Organization
Contact information
Practice address
15574 ROUTE 108, CARLINVILLE, IL 62626-4091
(121) 785-4431
Mailing address
15574 ROUTE 108, CARLINVILLE, IL 62626-4091
(121) 785-4431
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649460510
—
IL
Enumeration date
07/20/2007
Last updated
06/09/2023
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