Organization · Type 2 NPI

Crossroads Physician Corp

Family Medicine Physician · Mount Vernon, IL

NPI number 1699769612 Active

Practice location

209 Crossroads Pl, Suite 150
Mount Vernon, IL 62864-6254

Fax (618) 244-7299

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

16 other providers at this address

Other family medicine physician providers in Mount Vernon

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NPI record

NPI: 1699769612
Entity type: Organization (Type 2)
Issued: Sep 6, 2005
Last updated: Sep 18, 2007
Status: Active
Subpart: Yes of Crossroads Physician Corp

Other names

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Crossroads Family Associates #2 · doing business as

Authorized official

Debbie T Brewer
Director of Provider Enrollment
(615) 465-7626

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1699769612

Crossroads Physician Corp's National Provider Identifier is 1699769612, issued on Sep 6, 2005. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Mount Vernon, IL. The record was last updated on Sep 18, 2007.