Healthcare Provider Details

I. General information

NPI: 1780894949
Provider Name (Legal Business Name): LIGE M KAPLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 E CHAUNCEY LN
PHOENIX AZ
85054-5178
US

IV. Provider business mailing address

30575 WOODWARD AVE
ROYAL OAK MI
48073-0980
US

V. Phone/Fax

Practice location:
  • Phone: 602-726-8805
  • Fax: 623-873-8565
Mailing address:
  • Phone: 248-280-8550
  • Fax: 248-280-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301080400
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number57750
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: