Sikeston Surgical Specialist, LLC

NPI #1386058170 in Sikeston, Missouri

Provider Information

NPI Number: 1386058170
Entity Type: Organization
Organization Name: Sikeston Surgical Specialist, LLC
Primary Specialty: Surgery
Enumeration Date: Jun 19, 2014
Last Updated: Aug 15, 2014

Practice Location

Address: 1226 LINN ST
Address 2: SUITE B
City: Sikeston
State: Missouri
ZIP Code: 63801-5200
Phone: (573) 475-8599

Authorized Official

Name: DR. HOLLIS TIDMORE, MD
Title: OWNER
Phone: (573) 475-8599

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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