Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sikeston Surgical Specialist, LLC

Organization Surgery Physician · NPI 1386058170

Sikeston Surgical Specialist, LLC is a Surgery Physician in Sikeston, Missouri. Licensed in Missouri. Registered with an NPI since 2014.

Licensed in
MO
In the registry since
2014
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

1226 Linn St Ste B
Sikeston, MO 63801-5200
Phone: (573) 475-8599
Fax: (573) 475-8596
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 2009005897 (MO)

Record details

NPI number1386058170
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hollis Tidmore — Owner · (573) 475-8599
NPI enumeratedJune 19, 2014
Last updated in NPPESAugust 15, 2014
Mailing address1226 Linn St, Suite B, Sikeston, MO 63801-5200

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