MEDICARE: DR. JOHN MICHAEL CHIPKO JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	TRN17863	FL
2	2086S0127X	Trauma Surgery Physician	0064724	CO
3	2086S0127X	Trauma Surgery Physician	2019030236	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548553456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MICHAEL CHIPKO JR. M.D.

Provider Business Mailing Address
First Line	:	2330 E MEYER BLVD STE 209
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1149
Country	:	US
Telephone Number	:	203-982-4399
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD STE 209
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1149
Country	:	US
Telephone Number	:	816-235-3932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2011
Last Update Date	:	05/11/2022

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