Organization
DEXTER HOSPTIAL LLC
Active
Other names
DEXTER INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
SUE ANN WILLIAMS (CLINIC ADMINISTRATOR)
(573) 624-1640
Entity
Organization
Contact information
Practice address
1300 N ONE MILE RD, SUITE 1, DEXTER, MO 63841
(573) 624-7788
Mailing address
PO BOX 368, DEXTER, MO 63841
(573) 624-3165
(573) 624-3157
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC5219
RAILROAD MEDICARE
MO
Enumeration date
12/11/2006
Last updated
04/09/2008
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