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Organization

FAMILY MEDICINE OF SOUTHEAST MISSOURI, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKI JANE ROBERTS M.D. (OWNER)
(573) 620-6444
Entity
Organization

Contact information

Practice address
808 E WAKEFIELD AVE, SIKESTON, MO 63801-5147
(573) 620-6444
Mailing address
808 E. WAKEFIELD AVENUE, FAMILY MEDCINE OF SOUTHEAST MISSOURI, SIKESTON, MO 63801-5100
(573) 620-6444
(888) 654-6599

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
261QR1300X
Rural Health Clinic/Center
2005013758
MO

Other

Enumeration date
02/13/2008
Last updated
09/08/2011
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