Organization
SOUTHEAST MISSOURI UROLOGY CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINZA TAYLOR KILLION MD (CEO)
(573) 471-8656
Entity
Organization
Contact information
Practice address
1106 N MAIN ST, SIKESTON, MO 63801-5046
(573) 471-8656
(573) 471-8491
Mailing address
1106 N MAIN ST, SIKESTON, MO 63801-5046
(573) 471-8656
(573) 471-8491
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH8712
RR MEDICARE
—
Enumeration date
10/17/2005
Last updated
10/03/2007
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