Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 58879 | AZ |
NPI | 1003251463 |
---|---|
Provider Name | Dr. Jeremy Harris Kaplan |
First Address | Kingman, AZ 86409-3619 |
Second Address | Kingman, AZ 86409-3593 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 26/07/2019 |