Organization
JACKSONVILLE PEDIATRIC ASSOCIATES, 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
1600 W WALNUT ST, EAST WING, 3RD FLOOR, JACKSONVILLE, IL 62650-1136
(217) 245-5437
(217) 243-3113
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(800) 577-5368
(217) 757-2021
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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