Provider Demographics
NPI:1871546507
Name:KUPLIC, JAMES DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:KUPLIC
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2105 E ENTERPRISE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7862
Mailing Address - Country:US
Mailing Address - Phone:920-560-1000
Mailing Address - Fax:920-731-6732
Practice Address - Street 1:2105 E ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-7862
Practice Address - Country:US
Practice Address - Phone:920-560-1000
Practice Address - Fax:920-731-6732
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI37759207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32242000Medicaid
WIG29480Medicare UPIN