MEDICARE: DR. KENNETH GIMPLE 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
1	207X00000X	Orthopaedic Surgery Physician	04 17836	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200032752	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891770335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH GIMPLE MD

Provider Business Mailing Address
First Line	:	6001 SW 6TH AVE
Second Line	:	STE 200
City	:	TOPEKA
State	:	KS
Zip	:	66615-1011
Country	:	US
Telephone Number	:	785-233-7491
Fax Number	:	785-233-3187

Provider Business Practice Location Address
First Line	:	6001 SW 6TH AVE
Second Line	:	STE 200
City	:	TOPEKA
State	:	KS
Zip	:	66615-1011
Country	:	US
Telephone Number	:	785-233-7491
Fax Number	:	785-233-3187

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	10/12/2010

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