Organization
DEXTER HOSPITAL LLC
Active
Other names
MSH GENER AL SURGERY
Organization subpart
No
Provider details
NPI number
Authorized official
SUE A WILLIAMS (ASSISTANT ADMINISTRATOR)
(573) 614-1951
Entity
Organization
Contact information
Practice address
1300 N ONE MILE RD, SUITE 7, DEXTER, MO 63841
(573) 624-9936
Mailing address
PO BOX 368, DEXTER, MO 63841
(573) 624-3165
(573) 624-3157
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507576106
—
MO
01
—
DC5219
RAILROAD MEDICARE
MO
Enumeration date
12/21/2006
Last updated
10/18/2013
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