Individual
MARK F GORTMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
ONE HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2568
(573) 882-2226
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2004016548
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127254
BLUE SHIELD/BLUE CHOICE
MO
05
—
5752614
—
SD
01
—
686272
HEALTHLINK
MO
Enumeration date
02/13/2006
Last updated
08/14/2023
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