| Mercy Clinic Joplin Llc | |
| 
					101 W Sycamore St Columbus KS 66725  | |
| (620) 429-3636 | |
| Not Available | 
| Full Name | Mercy Clinic Joplin Llc | 
|---|---|
| Speciality | Clinic/center - Rural Health | 
| Location | 101 W Sycamore St, Columbus, Kansas | 
| Authorized Official Name and Position | Tracy A Godfrey (PRESIDENT) | 
| Authorized Official Contact | 4175568962 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mercy Clinic Joplin Llc 645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133  | Mercy Clinic Joplin Llc 101 W Sycamore St Columbus KS 66725 Ph: (620) 429-3636  | 
| NPI Number | 1750618351 | 
|---|---|
| Provider Enumeration Date | 11/03/2009 | 
| Last Update Date | 06/11/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1750618351 | NPI | - | NPPES | 
| 1750618351 | Medicaid | MO | |
| 200639810E | Medicaid | KS | |
| 1750618351 | Other | KS | KANSAS BLUE CROSS | 
| 615149203 | Other | KS | DEPARTMENT OF LABOR (OWCP-FECA) | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (Kansas) | Primary | 
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