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NPI Code Detail

MEDICARE: REGINALD L VERNIER

MEDICARE: REGINALD L VERNIER
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
1261QR1300XRural Health Clinic/Center036082451IL

General Provider Information

NPI Number : 1760660567
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGINALD L VERNIER
Provider Business Mailing Address
First Line : 500 S SCOTT AVE
Second Line :
City : NEWTON
State : IL
Zip : 62448-1665
Country : US
Telephone Number : 618-783-8713
Fax Number : 618-783-4170
Provider Business Practice Location Address
First Line : 500 S SCOTT AVE
Second Line :
City : NEWTON
State : IL
Zip : 62448-1665
Country : US
Telephone Number : 618-783-8713
Fax Number : 618-783-4170
Authorized Official
Title or Position : OWNER
Name : DR. REGINALD L VERNIER
Credential :
Telephone Number : 618-783-8713
Provider Enumeration Date : 02/04/2008
Last Update Date : 07/29/2008

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Directions to “REGINALD L VERNIER ” Practice Location

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