Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME106488 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME106488 | FL |
NPI | 1861499451 |
---|---|
Provider Name | James Michael Kerpsack |
First Address | Palm Beach Gardens, FL 33410-4625 |
Second Address | West Palm Beach, FL 33411-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 14/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200509720 | (05) | IN |
H79734 | (02) |