Healthcare Provider Details

I. General information

NPI: 1962043059
Provider Name (Legal Business Name): SCOTT KEPINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2019
Last Update Date: 10/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WATERDAM RD
MC MURRAY PA
15317-2567
US

IV. Provider business mailing address

7009 LAWRENCE DR
BETHEL PARK PA
15102-3915
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-2429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT028114
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: