MEDICARE: DR. GEORGE GEORGEKOPOULOS 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	2850	OH

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	7286054	OTHER	OH	AETNA
3	000000248786	OTHER	OH	ANTHEM BC/BS

General Provider Information

NPI Number	:	1073547576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE GEORGEKOPOULOS D.C.

Provider Business Mailing Address
First Line	:	204 WAKEFIELD RUN BLVD
Second Line	:
City	:	HINCKLEY
State	:	OH
Zip	:	44233-9222
Country	:	US
Telephone Number	:	330-705-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 WAKEFIELD RUN BLVD
Second Line	:
City	:	HINCKLEY
State	:	OH
Zip	:	44233-9222
Country	:	US
Telephone Number	:	330-705-0860
Fax Number	:

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	01/20/2017

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