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Organization
MERCY CLINIC JOPLIN LLC
Active
Organization
MERCY CLINIC JOPLIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY A GODFREY MD (PRESIDENT)
(417) 556-8962
Entity
Organization
Contact information
Practice address
310 2ND AVE SW, MIAMI, OK 74354-6743
(417) 556-8600
(417) 556-8602
Mailing address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 556-8994
(417) 556-8962
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
NULL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
05/04/2012
Last updated
07/02/2015
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