MEDICARE: DR. DAVID IRA PAPISH D.O.

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	207Q00000X	Family Medicine Physician	05-18527	KS

General Provider Information

NPI Number	:	1194831362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID IRA PAPISH D.O.

Provider Business Mailing Address
First Line	:	101 E ROSS ST
Second Line	:	PO BOX 308
City	:	CLEARWATER
State	:	KS
Zip	:	67026-7824
Country	:	US
Telephone Number	:	620-584-2055
Fax Number	:	620-584-2032

Provider Business Practice Location Address
First Line	:	101 E ROSS ST
Second Line	:
City	:	CLEARWATER
State	:	KS
Zip	:	67026-7824
Country	:	US
Telephone Number	:	620-584-2055
Fax Number	:	620-584-2032

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/08/2007

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