Provider Demographics
NPI:1174719710
Name:EPPERLY, STEPHEN L (CO)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:L
Last Name:EPPERLY
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Gender:M
Credentials:CO
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Mailing Address - Street 1:1677 WESTBROOK PLAZA DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3065
Mailing Address - Country:US
Mailing Address - Phone:336-765-2425
Mailing Address - Fax:336-765-8370
Practice Address - Street 1:1677 WESTBROOK PLAZA DR
Practice Address - Street 2:SUITE 190
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3065
Practice Address - Country:US
Practice Address - Phone:336-765-2425
Practice Address - Fax:336-765-8370
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2009-09-17
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795210Medicaid