# SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MERCY HOSPITAL STODDARD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679041040
- **Authorized official:** KRISTA BERRY (CFO)
- **Authorized official phone:** (573) 331-6028

## Contact information

- **Practice address:** 522 VIRGINIA ST, SIKESTON, MO 63801-5812
- **Practice address phone:** (573) 624-1901
- **Mailing address:** 1200 N ONE MILE RD, DEXTER, MO 63841-1015
- **Mailing address phone:** (573) 614-1900
- **Mailing address fax:** (573) 624-8895

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/05/2018
- **Last updated:** 09/16/2025