Healthcare Provider Details

I. General information

NPI: 1093924102
Provider Name (Legal Business Name): PHILIP L KAPLAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6224 FAYETTEVILLE RD STE 105
DURHAM NC
27713-6288
US

IV. Provider business mailing address

6224 FAYETTEVILLE RD STE 105
DURHAM NC
27713-6288
US

V. Phone/Fax

Practice location:
  • Phone: 919-439-6120
  • Fax: 919-246-4420
Mailing address:
  • Phone: 919-439-6120
  • Fax: 919-246-4420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberSI002337
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number5751
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY002194
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: