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General NPI Number Information
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NPI Number | 1427369313
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Entity Type | Individual
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Provider Name | ANTONIO ALBERTO CUMMINGS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 10/09/2019
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Provider Practice Location Address
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Address Line | 405 W JACKSON ST
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City | CARBONDALE
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State | IL
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Zip | 62901
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Country | US
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Telephone | 618-549-0721
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Fax | 618-457-0469
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Provider Business Mailing Address
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Address Line | 1239 E MAIN ST
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City | CARBONDALE
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State | IL
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Zip | 62901-3175
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Country | US
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Telephone | 618-457-5200
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Fax | 618-529-0586
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 125.057966
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036131709
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036.131709
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License Number State | IL
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