Individual
JAN BOWMAN-MARSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 W DEYOUNG ST, MARION, IL 62959-5884
(618) 998-7492
(618) 998-7493
Mailing address
PO BOX 708850, SANDY, UT 84070-8850
(866) 869-2397
(801) 352-9502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036076429
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036076429
BCBS
IL
05
—
036076429
—
IL
01
—
P00172788
RAIL ROAD MEDICARE
IL
Enumeration date
03/29/2006
Last updated
05/28/2008
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