# MERCY CLINIC JOPLIN LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356739288
- **Authorized official:** DR. TRACY A GODFREY MD (DIVISION VICE PRESIDENT)
- **Authorized official phone:** (417) 627-8962

## Contact information

- **Practice address:** 214 CARTER ST, BERRYVILLE, AR 72616-4303
- **Practice address phone:** (870) 423-5203
- **Practice address fax:** (870) 423-5178
- **Mailing address:** 3016 MCCLELLAND BLVD, JOPLIN, MO 64804-1637
- **Mailing address phone:** (417) 627-8962
- **Mailing address fax:** (417) 627-8961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | — |

## Other

- **Enumeration date:** 12/30/2014
- **Last updated:** 12/30/2014