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1073597266

NPI Code Detail

MEDICARE: DR. PETER PAUL KOBILSEK M.D.

MEDICARE: DR. PETER PAUL KOBILSEK 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	207L00000X	Anesthesiology Physician	MD421749	PA
2	207L00000X	Anesthesiology Physician	2007010594	MO
3	207L00000X	Anesthesiology Physician	E-4539	AR
4	207L00000X	Anesthesiology Physician	E4539	AR
5	207L00000X	Anesthesiology Physician	25499	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00656491	OTHER	OK	RAILROAD MEDICARE

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	:	1073597266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER PAUL KOBILSEK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3810
Second Line	:
City	:	JOPLIN
State	:	MO
Zip	:	64803-3810
Country	:	US
Telephone Number	:	417-347-1078
Fax Number	:	417-347-1079

Provider Business Practice Location Address
First Line	:	3401 N BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-5189
Country	:	US
Telephone Number	:	215-707-3326
Fax Number	:	215-707-8028

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	01/15/2020

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Directions to “ DR. PETER PAUL KOBILSEK M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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