Individual
JULIE HOFFMANN JANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
(417) 208-3625
Mailing address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
(417) 208-3625
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005032729
MO
208M00000X
Hospitalist Physician
Primary
2005032729
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110231924
RR MEDICARE
AZ
01
—
205413
BCBS
MO
05
—
208326009
—
MO
05
—
515885
—
AZ
01
—
AZ0710370
BC/BS OF AZ
AZ
01
—
P00297190
RR MEDICARE
MO
Enumeration date
04/07/2006
Last updated
08/15/2017
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