OrganizationActive
Crossroads Physician Corp
NPI 1780678797 · Family Medicine Physician · Mount Vernon, IL
Provider details
- NPI number
- 1780678797
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Crossroads Physician Corp
- Organization subpart
- Yes
- Authorized official
- Debbie Brewer, Director of Provider Enrollment(615) 465-7626
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
209 Crossroads Pl
Suite 120
Mount Vernon, IL 62864-6254
Phone: (618) 242-3119
Fax: (618) 242-3132
Approximate (ZIP-level) locationGet directions
Mailing address
209 Crossroads Pl
Mount Vernon, IL 62864-6254
Other names (DBA / former)
- Doing business as
- Crossroads Family Associates #1
Registry dates
- Enumerated
- 2005-09-06
- Last updated
- 2008-01-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.