# MEDICAL SPECIALISTS OF SOUTHEAST MISSOURI, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629052063
- **Authorized official:** DR. CHARLES E LAVALLE M.D. (OWNER)
- **Authorized official phone:** (573) 334-4822

## Contact information

- **Practice address:** 211 SAINT FRANCIS DR, ATTN INFECTIOUS DISEASE DEPT, CAPE GIRARDEAU, MO 63703-5049
- **Practice address phone:** (573) 331-3000
- **Practice address fax:** (573) 331-3000
- **Mailing address:** PO BOX 191850, SAINT LOUIS, MO 63119-7850
- **Mailing address phone:** (314) 821-8055
- **Mailing address fax:** (314) 821-1833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 100253 | MO | Yes |

## Other

- **Enumeration date:** 11/30/2005
- **Last updated:** 10/16/2007