| Southeast Primary Care - Broadway | |
|
1723 Broadway St Suite 205 Cape Girardeau MO 63701-4566 | |
| (573) 331-7930 | |
| Not Available |
| Full Name | Southeast Primary Care - Broadway |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1723 Broadway St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Hubert King (VICE PRES CFO) |
| Authorized Official Contact | 5733344822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Primary Care - Broadway 1723 Broadway St Suite 205 Cape Girardeau MO 63701-4566 Ph: (573) 331-7930 | Southeast Primary Care - Broadway 1723 Broadway St Suite 205 Cape Girardeau MO 63701-4566 Ph: (573) 331-7930 |
| NPI Number | 1780982215 |
|---|---|
| Provider Enumeration Date | 03/08/2011 |
| Last Update Date | 12/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780982215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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