Provider Demographics
NPI:1609862895
Name:APPLEMAN, KATHLEEN K (DPM)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:K
Last Name:APPLEMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1624
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63702-1624
Mailing Address - Country:US
Mailing Address - Phone:573-335-3668
Mailing Address - Fax:573-335-3620
Practice Address - Street 1:55 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4927
Practice Address - Country:US
Practice Address - Phone:573-335-3668
Practice Address - Fax:573-335-3620
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000776213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO303984108Medicaid
MO303984108Medicaid
MO000021446Medicare ID - Type Unspecified