| Mercy Southeast Pediatrics | |
|
25 Doctors Park Cape Girardeau MO 63703-4927 | |
| (573) 331-6750 | |
| (573) 331-6779 |
| Full Name | Mercy Southeast Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 Doctors Park, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Krista Berry (CFO) |
| Authorized Official Contact | 5733316028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Southeast Pediatrics 25 Doctors Park Cape Girardeau MO 63703-4927 Ph: (573) 331-6750 | Mercy Southeast Pediatrics 25 Doctors Park Cape Girardeau MO 63703-4927 Ph: (573) 331-6750 |
| NPI Number | 1619245503 |
|---|---|
| Provider Enumeration Date | 12/06/2011 |
| Last Update Date | 01/13/2024 |
| Medicare PECOS PAC ID | 9133024334 |
|---|---|
| Medicare Enrollment ID | O20120307000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619245503 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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