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NPI Code Detail

MEDICARE: PHYLLIS JEAN KAPELLEN M.D.

MEDICARE: PHYLLIS JEAN KAPELLEN M.D.
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
12085R0202XDiagnostic Radiology Physician35086051OH
22085R0202XDiagnostic Radiology PhysicianME99800FL
32085R0202XDiagnostic Radiology Physician26030OK
42085R0202XDiagnostic Radiology Physician42462-20WI
52085R0202XDiagnostic Radiology PhysicianN5147TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922055730
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHYLLIS JEAN KAPELLEN M.D.
Provider Business Mailing Address
First Line : 417 E NATASHA CT
Second Line :
City : TUCSON
State : AZ
Zip : 85737-7383
Country : US
Telephone Number : 520-989-9994
Fax Number :
Provider Business Practice Location Address
First Line : 417 E NATASHA CT
Second Line :
City : TUCSON
State : AZ
Zip : 85737-7383
Country : US
Telephone Number : 520-989-9994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 11/23/2015

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