MEDICARE: KENNETH A DECOURSEY, MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	131268	OTHER	MO	BLUE CROSS/BLUE SHIELD
2	180360	OTHER	MO	BLUE CROSS/BLUE SHIELD
3	0106771	OTHER		UNITED HEALTHCARE
4	649138	OTHER		HEALTHLINK

General Provider Information

NPI Number	:	1144278607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KENNETH A DECOURSEY, MD PC

Provider Business Mailing Address
First Line	:	5311 LEXINGTON ST
Second Line	:
City	:	JACKSON
State	:	MO
Zip	:	63755-3825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1723 BROADWAY ST
Second Line	:	SUITE 120
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-4505
Country	:	US
Telephone Number	:	573-334-7194
Fax Number	:	573-334-4937

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENNETH A DECOURSEY
Credential	:	M.D.
Telephone Number	:	573-334-7194

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1801893979 — DR. PAIROTE JAROONWANICHKUL MD
Practice Location Address:

1723 BROADWAY ST , SUITE 315
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-331-6476
Practice Fax: 573-331-6526

1043281413 — DR. AARON LANG M.D.
Practice Location Address:

1723 BROADWAY ST , SUITE 315
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-332-0226
Practice Fax: 573-332-0344

1588609929 — HEMATOLOGY ONCOLOGY ASSOCIATES LLC
Practice Location Address:

1723 BROADWAY ST , SUITE 315
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-332-0226
Practice Fax: 573-332-0344

1336247915 — MATTHEW D GAETA MD
Practice Location Address:

1723 BROADWAY ST , SUITE 220
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-331-7910
Practice Fax: 573-331-7919

1326239013 — MARGARET A WILLIAMS APRN
Practice Location Address:

1723 BROADWAY ST , SUITE 310
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-331-7880
Practice Fax: 573-331-6887

1841471307 — DEBRA M ALEXANDER MSN, APRN, BC-FNP
Practice Location Address:

1723 BROADWAY ST , SUITE 410
CAPE GIRARDEAU, MO
63701-4505

Practice Phone: 573-339-1957
Practice Fax: 573-339-9709

Directions to “KENNETH A DECOURSEY, MD PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.