| Southeasthealth Family Medicine Of Dexer | |
|
1200 N One Mile Rd Dexter MO 63841-1000 | |
| (573) 624-7575 | |
| Not Available |
| Full Name | Southeasthealth Family Medicine Of Dexer |
|---|---|
| Speciality | Family Medicine |
| Location | 1200 N One Mile Rd, Dexter, Missouri |
| Authorized Official Name and Position | Paula E Harris (VICE PRESIDENT REGIONAL OPERATIONS) |
| Authorized Official Contact | 5737780020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeasthealth Family Medicine Of Dexer Po Box 368 Dexter MO 63841 Ph: (573) 624-3165 | Southeasthealth Family Medicine Of Dexer 1200 N One Mile Rd Dexter MO 63841-1000 Ph: (573) 624-7575 |
| NPI Number | 1568524437 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 09/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568524437 | NPI | - | NPPES |
| DC5315 | Other | MO | RAILROAD MEDICARE |
| 509684809 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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