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Organization

MERCY CLINIC JOPLIN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATHEW JANSSENS (CFO)
(417) 556-2459
Entity
Organization

Contact information

Practice address
101 W SYCAMORE ST, COLUMBUS, KS 66725-1276
(620) 429-3636
Mailing address
PO BOX 504944, SAINT LOUIS, MO 63150-0001
(314) 466-6428

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
208600000X
Surgery Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043547474
KANSAS BLUE CROSS
KS
05
1043547474
MO
05
200639810B
KS
Enumeration date
11/05/2009
Last updated
04/30/2025
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