| Kenneth A Decoursey, Md Pc | |
|
1723 Broadway St Suite 120 Cape Girardeau MO 63701-4505 | |
| (573) 334-7194 | |
| (573) 334-4937 |
| Full Name | Kenneth A Decoursey, Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1723 Broadway St, Cape Girardeau, Missouri |
| Authorized Official Name and Position | Kenneth A Decoursey (PRESIDENT) |
| Authorized Official Contact | 5733347194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth A Decoursey, Md Pc 5311 Lexington St Jackson MO 63755-3825 Ph: () - | Kenneth A Decoursey, Md Pc 1723 Broadway St Suite 120 Cape Girardeau MO 63701-4505 Ph: (573) 334-7194 |
| NPI Number | 1144278607 |
|---|---|
| Provider Enumeration Date | 05/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144278607 | NPI | - | NPPES |
| 131268 | Other | MO | BLUE CROSS/BLUE SHIELD |
| 180360 | Other | MO | BLUE CROSS/BLUE SHIELD |
| 0106771 | Other | UNITED HEALTHCARE | |
| 649138 | Other | HEALTHLINK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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