Gaytan, Rafael J

Gaytan, Rafael J is an individual health care provider with primary practice located at 100 Mercy Way Suite 320-330, Joplin MO 64804-4524. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Gaytan, Rafael J can be contacted via phone (417) 781-5387.

Contact Information

Primary practice address
100 Mercy Way Suite 320-330 Joplin MO 64804-4524
Phone: (417) 781-5387
Fax: (417) 781-7174
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 2006038051 Missouri
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 2006038051 Missouri

Profile Details

NPI number 1376602649
LBN Legal business name Gaytan, Rafael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Mar 17th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376602649 NPPES
Kansas MEDICAID 200418840C
Kansas MEDICAID 200101900A
Kansas MEDICAID 206295701
Kansas Other P00800214

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