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NPI Code Detail

MEDICARE: GEORGE T KAPPOS MD

MEDICARE:   GEORGE T KAPPOS  MD
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
1207Q00000XFamily Medicine Physician21564IA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080108761OTHERIARR MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1467430090
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE T KAPPOS MD
Provider Business Mailing Address
First Line : 1010 S THIRD ST
Second Line : 1A
City : POLK CITY
State : IA
Zip : 50226-1165
Country : US
Telephone Number : 515-984-6426
Fax Number : 515-984-6428
Provider Business Practice Location Address
First Line : 1010 S 3RD ST
Second Line : 1A
City : POLK CITY
State : IA
Zip : 50226-1130
Country : US
Telephone Number : 515-984-6426
Fax Number : 515-984-6428
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2006
Last Update Date : 05/03/2011

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Directions to “ GEORGE T KAPPOS MD” Practice Location

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