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Organization
SOUTHEAST HOSPITAL BASED PHYSICIANS LLC
Active
Organization
SOUTHEAST HOSPITAL BASED PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HUBERT KING (CFO)
(573) 651-5870
Entity
Organization
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 331-6880
(573) 331-6887
Mailing address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 331-6880
(573) 331-6887
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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