Provider Demographics
NPI:1588606735
Name:KAPLAN, GORDON D (MD)
Entity Type:Individual
Prefix:
First Name:GORDON
Middle Name:D
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FLYNN DR STE 600
Mailing Address - Street 2:
Mailing Address - City:MILBANK
Mailing Address - State:SD
Mailing Address - Zip Code:57252-1557
Mailing Address - Country:US
Mailing Address - Phone:888-733-4428
Mailing Address - Fax:888-242-9992
Practice Address - Street 1:107 FLYNN DR STE 600
Practice Address - Street 2:
Practice Address - City:MILBANK
Practice Address - State:SD
Practice Address - Zip Code:57252-1557
Practice Address - Country:US
Practice Address - Phone:888-733-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-5174-K207P00000X
OH35.065174207P00000X
MN50872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKA4070045Medicare ID - Type Unspecified
OHF27247Medicare UPIN
OHKA4070046Medicare PIN
OH0928455Medicaid
OHKA4070046Medicare PIN