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General NPI Number Information
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NPI Number | 1386612653
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Entity Type | Individual
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Provider Name | JEFFREY B RAPP M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | COMMUNITY MEMORIAL HOSPITAL 512 SKYLINE BLVD
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City | CLOQUET
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State | MN
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Zip | 55720-1199
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Country | US
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Telephone | 218-879-4641
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Fax | 218-927-4130
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Provider Business Mailing Address
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Address Line | COMMUNITY MEMORIAL HOSPITAL 512 SKYLINE BLVD
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City | CLOQUET
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State | MN
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Zip | 55720-1199
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Country | US
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Telephone | 218-879-4641
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Fax | 218-927-4130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 42724
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License Number State | MN
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