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Organization

SEMO OTOLARYNGOLOGY HEAD & NECK SURGERY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY JEAN DEIMUND (OFFICE MANAGER)
(573) 335-4448
Entity
Organization

Contact information

Practice address
150 SOUTH MOUNT AUBURN ROAD, SUITE 420, CAPE GIRARDEAU, MO 63703
(573) 335-4448
(573) 335-4466
Mailing address
150 SOUTH MOUNT AUBURN ROAD, SUITE 420, CAPE GIRARDEAU, MO 63703
(573) 335-4448
(573) 335-4466

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
2001021769
MO
207Y00000X
Otolaryngology Physician
MD108690
MO
207Y00000X
Otolaryngology Physician
Primary
R8494
MO

Other

Enumeration date
08/02/2006
Last updated
08/22/2020
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