Healthcare Provider Details

I. General information

NPI: 1649374208
Provider Name (Legal Business Name): MARIPAT L GATTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MERCY WAY
JOPLIN MO
64804-4524
US

IV. Provider business mailing address

100 MERCY WAY
JOPLIN MO
64804-4524
US

V. Phone/Fax

Practice location:
  • Phone: 417-556-2300
  • Fax:
Mailing address:
  • Phone: 417-556-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2011012786
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number28444
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34643-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: