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NPI Code Detail

MEDICARE: GIBSON COMMUNITY HOSPITAL ASSOCIATION

MEDICARE: GIBSON COMMUNITY HOSPITAL ASSOCIATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1210191OTHERILMEDICARE GROUP

General Provider Information

NPI Number : 1396945960
Entity Type Code : Organization
Provider Name (Legal Business Name) : GIBSON COMMUNITY HOSPITAL ASSOCIATION
Provider Business Mailing Address
First Line : 227 N MARKET ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-1123
Country : US
Telephone Number : 217-379-4864
Fax Number : 217-379-2604
Provider Business Practice Location Address
First Line : 227 N MARKET ST
Second Line :
City : PAXTON
State : IL
Zip : 60957-1123
Country : US
Telephone Number : 217-379-4864
Fax Number : 217-379-2604
Authorized Official
Title or Position : CEO
Name : ROBERT SCHMITT
Credential :
Telephone Number : 217-784-4251
Provider Enumeration Date : 07/23/2007
Last Update Date : 08/28/2007

Similar Medicare Providers

1992700595 — GIBSON COMMUNITY HOSPITAL ASSOCIATION
Practice Location Address:
227 N MARKET ST
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60957-1123
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Practice Fax: 217-379-6494
1104922236 — CELIA A HETHKE RNC, ANP, APN
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1053632406 — DR. DONALD PEARSON REESE M.D.
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1477800175 — MRS. KELLI MARIE VAUGHN FNP-BC
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60957-1123
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Practice Fax:
1083154033 — SHELBY WARNER ARNP
Practice Location Address:
227 N MARKET ST
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1831742204 — KELLY DAWN COOKE PT, DPT
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Directions to “GIBSON COMMUNITY HOSPITAL ASSOCIATION ” Practice Location

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