Organization
MERCY CLINIC JOPLIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY A GODFREY MD (DIVISION VICE PRESIDENT)
(417) 627-8962
Entity
Organization
Contact information
Practice address
214 CARTER ST, BERRYVILLE, AR 72616-4303
(870) 423-5203
(870) 423-5178
Mailing address
3016 MCCLELLAND BLVD, JOPLIN, MO 64804-1637
(417) 627-8962
(417) 627-8961
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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