| Organization Name: | GEORGE T. KAPPOS, MD |
| NPI Number: | 1124357991 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE T. KAPPOS (OWNER) |
| Mailing Address: | 109 2nd Street Polk City |
| State: | IA US |
| Postal Code: | 50226 |
| Phone Number: | 5159846426 |
| Fax Number: | 5159846428 |
| NPI Enumeration Date: | 12/08/2009 |
| NPI Last Update Date: | 05/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 21564 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |