Provider Demographics
NPI:1841206513
Name:KAPLAN, LARRY KAPLAN
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:KAPLAN
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-1213
Mailing Address - Country:US
Mailing Address - Phone:248-437-3500
Mailing Address - Fax:248-437-3500
Practice Address - Street 1:410 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1213
Practice Address - Country:US
Practice Address - Phone:248-437-3500
Practice Address - Fax:248-437-3500
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILK005231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2583780Medicaid
MI950F351110OtherBCBS
MI0F35111Medicare ID - Type Unspecified
MI2583780Medicaid