MEDICARE: DR. PERCY D. KEPFER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0022120	FL
2	208000000X	Pediatrics Physician	ME0022120	FL

General Provider Information

NPI Number	:	1053533760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PERCY D. KEPFER MD

Provider Business Mailing Address
First Line	:	4018 GREENWOOD DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6151
Country	:	US
Telephone Number	:	772-464-2607
Fax Number	:	772-464-4525

Provider Business Practice Location Address
First Line	:	4018 GREENWOOD DR
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-6151
Country	:	US
Telephone Number	:	772-464-2607
Fax Number	:	772-464-4525

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	03/07/2014

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