Individual
DR. KEVIN BRADLEY GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6812 STATE ROUTE 162, SUITE 204, MARYVILLE, IL 62062-8553
(618) 288-2120
(618) 288-2123
Mailing address
6812 STATE ROUTE 162, SUITE 204, MARYVILLE, IL 62062-8553
(618) 288-2120
(618) 288-2123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036074997
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036074997
—
IL
Enumeration date
01/15/2007
Last updated
01/23/2013
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