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Organization

PASSAVANT PHYSICIAN ASSOCIATION

Active
Parent organization
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
Authorized official
MR. STEPHEN G LEE (PHYSICIAN SERVICES OFFICER)
(217) 479-5890
Entity
Organization

Contact information

Practice address
557 N WESTGATE AVE, JACKSONVILLE, IL 62650-1156
(217) 243-5474
(217) 245-2322
Mailing address
557 N WESTGATE AVE, JACKSONVILLE, IL 62650-1156
(217) 243-5474
(217) 245-2322

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
05/27/2014
Last updated
06/02/2014
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