Organization
CLARK COUNTY FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY JO GALEENER (PRACTICE MGR)
(217) 382-4191
Entity
Organization
Contact information
Practice address
890 RIDGELAWN RD, MARTINSVILLE, IL 62442-0399
(217) 382-4191
(217) 382-4248
Mailing address
890 RIDGELAWN RD, PO BOX 399, MARTINSVILLE, IL 62442-0399
(217) 382-4191
(217) 382-4248
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DR9170
RAILROAD MEDICARE
—
Enumeration date
08/28/2012
Last updated
08/28/2012
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