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

Sullivan County Memorial Hospital

Organization Emergency Medicine Physician · NPI 1063553642

Sullivan County Memorial Hospital is an Emergency Medicine Physician in Milan, Missouri. Licensed in Missouri. Registered with an NPI since 2007.

Licensed in
MO
In the registry since
2007

Practice location Address checks out

630 W 3rd St
Milan, MO 63556-1076
Phone: (660) 265-4212
Fax: (660) 265-4898
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 130-49 (MO)

Record details

NPI number1063553642
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Michael — Chief Financial Officer · (660) 265-4212
NPI enumeratedFebruary 8, 2007
Last updated in NPPESMay 16, 2011
Mailing address630 W 3rd St, Milan, MO 63556-1076