Healthcare Provider Details

I. General information

NPI: 1649262635
Provider Name (Legal Business Name): JOHN FRANCIS PEPPIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 09/18/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 KY HIGHWAY 36 E UNIT 1
CYNTHIANA KY
41031-7498
US

IV. Provider business mailing address

1210 KY HIGHWAY 36 E UNIT 1
CYNTHIANA KY
41031-7498
US

V. Phone/Fax

Practice location:
  • Phone: 859-234-4494
  • Fax: 859-234-4498
Mailing address:
  • Phone: 859-234-2300
  • Fax: 859-234-4498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number03020
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34998
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number03083
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: