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General NPI Number Information
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NPI Number | 1861475261
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Entity Type | Individual
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Provider Name | PATRICK MASCHING MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 400 MAPLE SUMMIT RD
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City | JERSEYVILLE
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State | IL
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Zip | 62052-2028
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Country | US
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Telephone | 618-498-6402
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 RIVERS EDGE DR
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City | COOKEVILLE
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State | TN
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Zip | 38506-1012
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Country | US
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Telephone | 618-971-8401
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Fax |
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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 | 62866
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036092388
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62866
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036-092388
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License Number State | IL
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