# SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC
- **Other names:** MERCY SOUTHEAST PEDIATRICS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619245503
- **Legal business name:** SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC
- **Authorized official:** KRISTA BERRY (CFO)
- **Authorized official phone:** (573) 331-6028

## Contact information

- **Practice address:** 25 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4927
- **Practice address phone:** (573) 331-6750
- **Practice address fax:** (573) 331-6779
- **Mailing address:** 25 DOCTORS PARK, CAPE GIRARDEAU, MO 63703-4927
- **Mailing address phone:** (573) 331-6750
- **Mailing address fax:** (573) 331-6779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/06/2011
- **Last updated:** 01/13/2024