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Contact Information

KENNETH A DECOURSEY, MD
1723 BROADWAY, SUITE 120
CAPE GIRARDEAU, MO63701
 Phone: 573-334-7194
 Fax: 573-334-4937
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for KENNETH A DECOURSEY · (Male)

NPI # 1356473797
Status Active
Credentials MD
Entity Individual
Enumeration date 03/12/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 102354
  • Other 649138 HEALTHLINK
  • Other DA3724 RAILROAD MEDICARE ID
  • Other P00056880 RAILROAD MEDICARE ID
  • Other 0106771 UNITED HEALTHCARE
  • MO Other 131268 BLUE CROSS BLUE SHIELD
  • MO Other 180360 BLUE CROSS BLUE SHIELD
Hospital affiliation(s)
  • MISSOURI DELTA MEDICAL CENTER - (Acute Care)
    1008 NORTH MAIN ST
    SIKESTON, MO 63801
  • MISSOURI SOUTHERN HEALTHCARE - (Acute Care)
    1200 N ONE MILE RD
    DEXTER, MO 63841
  • SOUTHEAST MISSOURI HOSPITAL - (Acute Care)
    1701 LACEY ST
    CAPE GIRARDEAU, MO 63701
  • ST FRANCIS MEDICAL CENTER - (Acute Care)
    211 ST FRANCIS DR
    CAPE GIRARDEAU, MO 63703
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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