Healthcare Provider Details

I. General information

NPI: 1588606735
Provider Name (Legal Business Name): GORDON D KAPLAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 FLYNN DR STE 600
MILBANK SD
57252-1557
US

IV. Provider business mailing address

107 FLYNN DR STE 600
MILBANK SD
57252-1557
US

V. Phone/Fax

Practice location:
  • Phone: 888-733-4428
  • Fax:
Mailing address:
  • Phone: 888-733-4428
  • Fax: 888-242-9992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35-06-5174-K
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.065174
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number50872
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: