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General NPI Number Information
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NPI Number | 1255641122
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Entity Type | Organization
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Legal Business Name | GERARD PAUL NAGORSKI DO PC
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 1235 W 64TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64113-1514
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Country | US
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Telephone | 816-444-6554
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Fax | 816-822-7017
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Provider Business Mailing Address
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Address Line | 1235 W 64TH ST
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City | KANSAS CITY
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State | MO
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Zip | 64113-1514
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Country | US
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Telephone | 816-444-6554
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Fax | 816-822-7017
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERARD PAUL NAGORSKI
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Credential | D.O.
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Telephone | 816-444-6554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31376
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License Number State | MO
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