# SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
- **Other names:** SoutheastHEALTH Family Medicine of Dexer
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568524437
- **Legal business name:** SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC
- **Authorized official:** PAULA E HARRIS (VICE PRESIDENT REGIONAL OPERATIONS)
- **Authorized official phone:** (573) 778-0020

## Contact information

- **Practice address:** 1200 N ONE MILE RD, DEXTER, MO 63841-1000
- **Practice address phone:** (573) 624-7575
- **Mailing address:** PO BOX 368, DEXTER, MO 63841
- **Mailing address phone:** (573) 624-3165
- **Mailing address fax:** (573) 624-3157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 09/22/2014