Provider Demographics
NPI:1922530666
Name:GORTES, FRANCISCO JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:GORTES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8252
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64508-8252
Mailing Address - Country:US
Mailing Address - Phone:816-271-7648
Mailing Address - Fax:816-271-7644
Practice Address - Street 1:3906 OAKLAND AVENUE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64505-8252
Practice Address - Country:US
Practice Address - Phone:816-271-7648
Practice Address - Fax:816-271-7644
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180120782085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty