Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 4032 | FL |
Y | 152W00000X | Optometrist | 5557 | OH |
N | 152W00000X | Optometrist | OPT.0003172 | CO |
NPI | 1003887928 |
---|---|
Provider Name | Dr. Brad Phillip Kaster |
First Address | Akron, OH 44312-5365 |
Second Address | Akron, OH 44312-5365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 25/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V02095 | (02) |