# SOUTHEASTHEALTH HOSPITAL HOLDINGS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHEASTHEALTH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053659904
- **Authorized official:** PAULA E HARRIS (VP REGIONAL OPERATIONS)
- **Authorized official phone:** (573) 778-0020

## Contact information

- **Practice address:** 2002 KANELL BLVD, POPLAR BLUFF, MO 63901-4045
- **Practice address phone:** (573) 778-0020
- **Practice address fax:** (573) 776-7548
- **Mailing address:** PO BOX 989, POPLAR BLUFF, MO 63902-0989
- **Mailing address phone:** (573) 778-0020
- **Mailing address fax:** (573) 776-7548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/28/2013
- **Last updated:** 03/04/2013