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General NPI Number Information
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NPI Number | 1629078407
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Entity Type | Individual
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Provider Name | PAUL OWEN GORBY DPM
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 09/09/2011
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Provider Practice Location Address
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Address Line | 550 RUSH CREEK PKWY SUITE A
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City | LIBERTY
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State | MO
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Zip | 64068-9608
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Country | US
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Telephone | 816-455-1155
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Fax | 816-455-1161
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Provider Business Mailing Address
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Address Line | 550 RUSH CREEK PKWY SUITE A
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City | LIBERTY
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State | MO
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Zip | 64068-9608
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Country | US
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Telephone | 816-455-1155
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Fax | 816-455-1161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 009612
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 12-00343
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License Number State | KS
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