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

Southeasthealth Hospital Holdings, LLC

Organization Family Medicine Physician · NPI 1053659904

Southeasthealth Hospital Holdings, LLC is a Family Medicine Physician in Poplar Bluff, Missouri. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
4
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) 778-0020
Fax: (573) 776-7548
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Foot & Ankle Surgery Podiatrist Taxonomy 213ES0103X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1053659904
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Paula Harris — Vp Regional Operations · (573) 778-0020
Other names Southeasthealth
NPI enumeratedJanuary 28, 2013
Last updated in NPPESMarch 4, 2013
Mailing addressPo Box 989, Poplar Bluff, MO 63902-0989

Other providers in Poplar Bluff