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General NPI Number Information
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NPI Number | 1164666988
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Entity Type | Organization
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Legal Business Name | MARSHALL BROWNING HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 905 N WASHINGTON ST
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City | DU QUOIN
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State | IL
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Zip | 62832-5601
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Country | US
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Telephone | 618-542-2146
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Fax | 618-542-5920
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Provider Business Mailing Address
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Address Line | PO BOX 192
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City | DU QUOIN
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State | IL
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Zip | 62832-0192
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Country | US
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Telephone | 618-542-2146
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Fax | 618-542-5920
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL EAVES
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Credential |
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Telephone | 618-542-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0001388
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License Number State | IL
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