Dawdy, John Kersey

Dawdy, John Kersey is an individual health care provider with primary practice located at 201 Health Care Dr , Greenville IL 62246-1155. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dawdy, John Kersey can be contacted via phone (618) 664-1380.

Contact Information

Primary practice address
201 Health Care Dr Greenville IL 62246-1155
Phone: (618) 664-1380
Fax: (618) 664-4239
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0036044169 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036044169 Illinois

Profile Details

NPI number 1598759201
LBN Legal business name Dawdy, John Kersey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Dec 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598759201 NPPES
Illinois MEDICAID 036044169

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