Healthcare Provider Details

I. General information

NPI: 1235190018
Provider Name (Legal Business Name): DAVID MILTON CULPEPPER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S 2ND ST
DANVILLE KY
40422-1804
US

IV. Provider business mailing address

212 S 2ND ST
DANVILLE KY
40422-1804
US

V. Phone/Fax

Practice location:
  • Phone: 859-209-2269
  • Fax:
Mailing address:
  • Phone: 859-209-2269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12403
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number53316
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: