Provider Demographics
NPI:1801877162
Name:KAPLAN, KENNETH R (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
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 1849
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04241-1849
Mailing Address - Country:US
Mailing Address - Phone:207-784-2554
Mailing Address - Fax:207-777-5363
Practice Address - Street 1:211 PARK STREET
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3143
Practice Address - Country:US
Practice Address - Phone:508-236-7750
Practice Address - Fax:508-223-3026
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA753962085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA410551OtherBLUE CHIP R
MA04-3140277OtherTRICARE
MA00000002835OtherHEALTH NET
MD4700OtherBCBS RI
MATUFTS HEALTH PLANOtherTUFTS HEALTH PLAN
MA7803794003OtherCIGNA MA
KYJ13152OtherBCBS MA
MA04-3140277OtherHCVM FIRST HEALTH
IA16-00012OtherUNITED HEALTHCARE RI
MA244478OtherHARVARD PILGRIM
MP300134591OtherRAILROAD MEDICARE
MA3095096Medicaid
MAP00601386OtherRR MEDICARE
MAP00601386OtherRR MEDICARE
F39848Medicare UPIN
MAJ13152Medicare PIN