=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861773327
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOSEPH F KASPER MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2011
-----------------------------------------------------
Last Update Date | 08/29/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12176 S 1000 E
-----------------------------------------------------
City | DRAPER
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84020-9734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-572-3750
-----------------------------------------------------
Fax | 801-572-1097
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12176 S 1000 E
-----------------------------------------------------
City | DRAPER
-----------------------------------------------------
State | UT
-----------------------------------------------------
Zip | 84020-9734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-572-3750
-----------------------------------------------------
Fax | 801-572-1097
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOSEPH F KASPER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 801-572-3750
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 3467441205
-----------------------------------------------------
License Number State | UT
-----------------------------------------------------