Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Southeast Health Center of Stoddard County, LLC

Organization Family Medicine Physician · NPI 1780927871

Southeast Health Center of Stoddard County, LLC provides Family Medicine Physician services in Poplar Bluff, Missouri. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2002 Kanell Blvd
Poplar Bluff, MO 63901-4045
Phone: (573) 727-9130
Fax: (573) 727-9128
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1780927871
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Krista Berry — Cfo · (573) 331-6028
Other names Mercy Hospital Stoddard
NPI enumeratedMarch 27, 2013
Last updated in NPPESSeptember 16, 2025
Certification dateSeptember 16, 2025
Mailing address1200 N One Mile Rd, Dexter, MO 63841-1015

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