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Missouri Delta Medical Center

Organization Active NPI Internal Medicine Physician · Sikeston, MO

NPI 1124103247 · NPPES record last updated Mar 3, 2015

Key facts

NPI
1124103247
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
MISSOURI DELTA MEDICAL CENTER
Practice address
1008 N Main St
Sikeston, MO 63801-5044
Phone
(573) 471-1600
Fax
(573) 472-7740
NPI assigned
Oct 26, 2006
Organization subpart
No

Authorized official

Name
Jason Schrumpf
Title
Ceo/President
Phone
(573) 472-7601

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Missouri Delta Medical Center (24 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RP1001X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0129X

Addresses

Primary practice location

1008 N Main St
Sikeston, MO 63801-5044

Mailing address

1008 N Main St
Sikeston, MO 63801-5044
Phone (573) 471-1600

Other identifiers

IdentifierTypeStateIssuer
505956706MedicaidMO

Other providers in Sikeston, MO

All providers in Sikeston, MO · Internal Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.