=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477502185
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT ALLEN KAPLAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 N 5TH ST
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | SD
-----------------------------------------------------
Zip | 57747-1480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 605-745-2000
-----------------------------------------------------
Fax | 605-745-2802
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1052 1111 RIVERBEND DRIVE
-----------------------------------------------------
City | DOUGLAS
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82633-1052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-359-0014
-----------------------------------------------------
Fax | 307-358-3820
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 2671A
-----------------------------------------------------
License Number State | WY
-----------------------------------------------------