# DEXTER HOSPITAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JIBBEN MEDICAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710056213
- **Authorized official:** MRS. SUE ANN WILLIAMS (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (573) 624-1640

## Contact information

- **Practice address:** 1525 W BUSINESS HWY 60, DEXTER, MO 63841
- **Practice address phone:** (573) 624-8447
- **Practice address fax:** (573) 624-4312
- **Mailing address:** PO BOX 368, DEXTER, MO 63841-0368
- **Mailing address phone:** (573) 624-3165
- **Mailing address fax:** (573) 624-3157

## 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:** 11/07/2006
- **Last updated:** 09/11/2008