Family Medicine of Southeast Missouri, LLC

NPI #1619145612 in Sikeston, Missouri

Provider Information

NPI Number: 1619145612
Entity Type: Organization
Organization Name: Family Medicine of Southeast Missouri, LLC
Primary Specialty: Family Medicine
Enumeration Date: Feb 13, 2008
Last Updated: Sep 8, 2011

Practice Location

Address: 808 E WAKEFIELD AVE
City: Sikeston
State: Missouri
ZIP Code: 63801-5147
Phone: (573) 620-6444

Authorized Official

Name: VICKI JANE ROBERTS, M.D.
Title: OWNER
Phone: (573) 620-6444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rural Health — Rural Health	261QR1300X
Family Medicine	207Q00000X	Primary

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