Individual
DR. JAMES BENJAMIN MIKEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 844-2001
Mailing address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 844-2001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-132877
IL
208000000X
Pediatrics Physician
036-132877
IL
Other
Enumeration date
03/27/2009
Last updated
12/19/2013
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