MEDICARE: DR. JAMIE HARRIS KAPNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	14167	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	340002015	OTHER	RR MED
2	AZ0181310	OTHER	BCBS
3	246670	OTHER	AHCCS

General Provider Information

NPI Number	:	1548255516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE HARRIS KAPNER MD

Provider Business Mailing Address
First Line	:	10250 N 92ND ST
Second Line	:	SUITE 118
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4510
Country	:	US
Telephone Number	:	480-860-6486
Fax Number	:	480-860-0896

Provider Business Practice Location Address
First Line	:	10250 N 92ND ST
Second Line	:	SUITE 118
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4510
Country	:	US
Telephone Number	:	480-860-6486
Fax Number	:	480-860-0896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	01/15/2010

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