Wegmann, Joey Alan

Wegmann, Joey Alan is an sole proprietor health care provider with primary practice located at 302 Broadway St , Mount Vernon IL 62864-5116. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Wegmann, Joey Alan can be contacted via phone (618) 242-4750.

Contact Information

Primary practice address
302 Broadway St Mount Vernon IL 62864-5116
Phone: (618) 242-4750
Fax: (618) 242-7674
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085000851 Illinois

Profile Details

NPI number 1376656827
LBN Legal business name Wegmann, Joey Alan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 17th, 2006
Last updated Feb 7th, 2013 - about 12 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 1376656827 NPPES
Illinois MEDICAID 085000851
Illinois Other 719926

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