MEDICARE: DR. KEVIN GORDON PAAPE D.C.

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	111N00000X	Chiropractor	691	ND

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063485084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN GORDON PAAPE D.C.

Provider Business Mailing Address
First Line	:	3240 15TH ST S
Second Line	:	STE C
City	:	FARGO
State	:	ND
Zip	:	58104-6188
Country	:	US
Telephone Number	:	701-451-9070
Fax Number	:	701-364-5318

Provider Business Practice Location Address
First Line	:	3290 20TH ST SW
Second Line	:	SUITE 4
City	:	FARGO
State	:	ND
Zip	:	58104-5917
Country	:	US
Telephone Number	:	701-451-9070
Fax Number	:	701-364-5318

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	02/24/2020

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