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Organization
SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC
Active
Organization
SOUTHEAST MISSOURI HOSPITAL PHYSICIANS, LLC
Active
Other names
MERCY CLINIC SOUTHEAST
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA BERRY (CFO)
(573) 331-6028
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
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
NULL
207RH0003X
Hematology & Oncology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
—
NULL
207W00000X
Ophthalmology Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
NULL
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084N0400X
Neurology Physician
—
NULL
2084N0400X
Neurology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/11/2006
Last updated
01/13/2024
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