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Organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC
Active
Organization
SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC
Active
Other names
MERCY HOSPITAL STODDARD
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BERRY (CFO)
(573) 331-6028
Entity
Organization
Contact information
Practice address
1200 N ONE MILE ROAD, DEXTER, MO 63841-1000
(573) 614-1900
(573) 624-8895
Mailing address
PO BOX 368, DEXTER, MO 63841-1000
(573) 614-1900
(573) 625-8895
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/19/2013
Last updated
01/13/2024
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