SOUTHEAST MISSOURI SURGERY CENTER NPI 1164388021

NPI Information

  • NPI: 1164388021
  • Provider Name: SOUTHEAST MISSOURI SURGERY CENTER
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Address: 65 DOCTORS PARK STE B
    CAPE GIRARDEAU, MO
    ZIP 63703
  • Phone: (573) 803-2420

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NPI Details

SOUTHEAST MISSOURI SURGERY CENTER is an ambulatory surgical clinic center in Cape Girardeau, MO. SOUTHEAST MISSOURI SURGERY CENTER NPI is 1164388021. The provider is registered as an organization entity type.

The provider's business location address is:

65 DOCTORS PARK STE B
CAPE GIRARDEAU, MO
ZIP 63703-927
Phone: (573) 803-2420
Fax: (573) 651-8734

The provider's authorized official is Sonjay Joseph Fonn .
The authorized official title is Owner and has the following contact phone number (573) 270-8365.

The enumeration date for this NPI number is 1/5/2026 and was last updated on 1/5/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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