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General NPI Number Information
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NPI Number | 1871664292
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Entity Type | Individual
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Provider Name | TODD E GARNER DO
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Gender | Male
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 600 LINCOLN AVE
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City | CHARLESTON
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State | IL
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Zip | 61920-3011
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Country | US
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Telephone | 217-581-3013
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Fax | 217-581-3899
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Provider Business Mailing Address
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Address Line | 1620 BROADMOOR
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City | MATTOON
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State | IL
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Zip | 61938
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Country | US
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Telephone | 217-246-6340
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Fax | 217-235-3131
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 336044388
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License Number State | IL
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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 | 36082071
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License Number State | IL
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