Healthcare Provider Details

I. General information

NPI: 1417979568
Provider Name (Legal Business Name): JAMES SCOTT HEPPLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 S CHESTNUT ST
ELLENSBURG WA
98926-3875
US

IV. Provider business mailing address

610 N 58TH AVE
YAKIMA WA
98908-2312
US

V. Phone/Fax

Practice location:
  • Phone: 509-962-9841
  • Fax:
Mailing address:
  • Phone: 509-966-1230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00036826
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: