Provider Demographics
NPI:1891798070
Name:KAPPAKAS, GEORGE S (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:S
Last Name:KAPPAKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BROOKS LN
Mailing Address - Street 2:SUITE G20
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3747
Mailing Address - Country:US
Mailing Address - Phone:412-267-5040
Mailing Address - Fax:412-384-3505
Practice Address - Street 1:1200 BROOKS LN
Practice Address - Street 2:SUITE G20
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3747
Practice Address - Country:US
Practice Address - Phone:412-267-5040
Practice Address - Fax:412-384-3505
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016757E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00771790Medicaid
PA01706357Medicaid
PA200031591Medicare ID - Type UnspecifiedRAILROAD
PAB35078Medicare UPIN
PAPI508429Medicare ID - Type UnspecifiedGROUP
PAKA076257Medicare ID - Type UnspecifiedINDIVIDUAL
PA00771790Medicaid