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Organization
FAMILY MEDICINE OF SOUTHEAST MISSOURI, LLC
Active
Organization
FAMILY MEDICINE OF SOUTHEAST MISSOURI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI JANE ROBERTS M.D. (OWNER)
(573) 620-6444
Entity
Organization
Contact information
Practice address
808 E WAKEFIELD AVE, SIKESTON, MO 63801-5147
(573) 620-6444
Mailing address
808 E. WAKEFIELD AVENUE, FAMILY MEDCINE OF SOUTHEAST MISSOURI, SIKESTON, MO 63801-5100
(573) 620-6444
(888) 654-6599
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
2005013758
MO
Other
Enumeration date
02/13/2008
Last updated
09/08/2011
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