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General NPI Number Information
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NPI Number | 1134659428
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Entity Type | Individual
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Provider Name | TIMOTHY BRETT ZEPPONI DO
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Gender | Male
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Dates
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Enumeration Date | 06/19/2017
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 300 S WASHINGTON AVE
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City | GREENVILLE
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State | MS
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Zip | 38701-4719
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Country | US
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Telephone | 662-344-9100
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Fax | 662-725-1154
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Provider Business Mailing Address
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Address Line | 1665 S GREEN ST
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City | TUPELO
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State | MS
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Zip | 38804-6556
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26701
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License Number State | MS
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