Organization
SAINT FRANCIS MEDICAL CENTER
Active
Organization
SAINT FRANCIS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE C WILKERSON (CREDENTIALING)
(573) 331-5583
Entity
Organization
Contact information
Practice address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703
(573) 331-5228
(573) 331-5016
Mailing address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 331-5228
(573) 331-5016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
102167
MO
174400000X
Specialist
2002005133
MO
174400000X
Specialist
2006008758
MO
174400000X
Specialist
2006015230
MO
174400000X
Specialist
R5H64
MO
174400000X
Specialist
Primary
R8D70
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001
ILLINOIS CAID INSTITUTION
MO
05
—
01060802
—
MO
01
—
01440833
KENTUCKY CAID
KY
01
—
110375
HEALTHLINK
MO
01
—
153
ANTHEM BLUECROSS BLUESHIELD
MO
01
—
3623
HEALTH ALLIANCE
MO
01
—
46165
GHP
MO
01
—
63703004
TRICARE PROVIDER #
MO
Enumeration date
05/04/2011
Last updated
06/08/2018
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