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General NPI Number Information
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NPI Number | 1891786091
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Entity Type | Individual
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Provider Name | JOHN VICTOR KASPAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 3821 ED DR
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City | RALEIGH
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State | NC
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Zip | 27612-8038
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Country | US
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Telephone | 919-758-8677
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Fax | 919-758-8723
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Provider Business Mailing Address
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Address Line | 3821 ED DR
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City | RALEIGH
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State | NC
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Zip | 27612-8038
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Country | US
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Telephone | 919-758-8677
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Fax | 919-758-8723
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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 | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | 9700609
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 9700609
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License Number State | NC
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