Organization · Type 2 NPI

Passavant Physician Association

Rural Health Clinic/Center · Jacksonville, IL

NPI number 1972054609 Active

Practice location

559 N Westgate Ave
Jacksonville, IL 62650-1156

Fax (217) 245-2322

Specialties and licenses

TaxonomyCodeLicense
Family Medicine Physician 207Q00000XNone listed
Internal Medicine Physician 207R00000XNone listed
Otolaryngology Physician 207Y00000XNone listed
Rural Health Clinic/Center Primary 261QR1300XNone listed

Rural Health Clinic/Center: Definition to come...

4 other providers at this address

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About NPI 1972054609

Passavant Physician Association's National Provider Identifier is 1972054609, issued on Oct 18, 2016. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Jacksonville, IL. The record was last updated on Apr 4, 2017.