Healthcare Provider Details

I. General information

NPI: 1821792243
Provider Name (Legal Business Name): MARSHALL EIPPERT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 GRAND AVE
NEWPORT KY
41071-2570
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-912-7193
  • Fax: 859-441-2230
Mailing address:
  • Phone: 859-344-5555
  • Fax: 859-344-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number06476
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: