MEDICARE: DR. JOHN P RAPACZ 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	207Q00000X	Family Medicine Physician	16137	OK

General Provider Information

NPI Number	:	1508858853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN P RAPACZ M.D.

Provider Business Mailing Address
First Line	:	1212 S DOUGLAS BLVD
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5213
Country	:	US
Telephone Number	:	405-736-6811
Fax Number	:	405-736-6863

Provider Business Practice Location Address
First Line	:	1212 S DOUGLAS BLVD
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-5213
Country	:	US
Telephone Number	:	405-736-6811
Fax Number	:	405-736-6863

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	02/26/2008

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