Healthcare Provider Details

I. General information

NPI: 1629128277
Provider Name (Legal Business Name): MISSOURI DELTA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 NORTH MAIN
SIKESTON MO
63801-5044
US

IV. Provider business mailing address

1008 N MAIN ST
SIKESTON MO
63801-5044
US

V. Phone/Fax

Practice location:
  • Phone: 573-471-1600
  • Fax: 573-472-7740
Mailing address:
  • Phone: 573-471-1600
  • Fax: 573-472-7740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JASON SCHRUMPF
Title or Position: CEO, PRESIDENT
Credential:
Phone: 573-472-7601