# 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:** Southeast Primary Care - Broadway
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780982215
- **Legal business name:** SOUTHEAST MISSOURI HOSPITAL PHYSICIANS LLC
- **Authorized official:** HUBERT KING (VICE PRES CFO)
- **Authorized official phone:** (573) 334-4822

## Contact information

- **Practice address:** 1723 BROADWAY ST, SUITE 205, CAPE GIRARDEAU, MO 63701-4566
- **Practice address phone:** (573) 331-7930
- **Mailing address:** 1723 BROADWAY ST, SUITE 205, CAPE GIRARDEAU, MO 63701-4566
- **Mailing address phone:** (573) 331-7930

## Taxonomy

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

## Other

- **Enumeration date:** 03/08/2011
- **Last updated:** 12/20/2012