Dexter Hospital LLC
Organization Active NPI Surgery Physician · Dexter, MO
NPI 1629132790 · NPPES record last updated Oct 18, 2013
Key facts
- NPI
- 1629132790
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- DEXTER HOSPITAL LLC
- Practice address
- 1300 N One Mile Rd
Suite 7
Dexter, MO 63841 - Phone
- (573) 624-9936
- NPI assigned
- Dec 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Sue A Williams
- Title
- Assistant Administrator
- Phone
- (573) 614-1951
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
1300 N One Mile Rd
Suite 7
Dexter, MO 63841
Mailing address
PO Box 368
Dexter, MO 63841
Phone (573) 624-3165
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 507576106 | Medicaid | MO | |
| DC5219 | Other | MO | RAILROAD MEDICARE |
Other names
- MSH GENER AL SURGERY
Other providers in Dexter, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.