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General NPI Number Information
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NPI Number | 1255384434
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Entity Type | Individual
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Provider Name | L. DOUGLAS PEPPER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 04/04/2023
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Provider Practice Location Address
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Address Line | 728 BROAD AVE
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City | BELLE VERNON
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State | PA
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Zip | 15012-1513
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Country | US
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Telephone | 724-929-2550
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Fax | 724-929-5676
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Provider Business Mailing Address
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Address Line | 728 BROAD AVE
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City | BELLE VERNON
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State | PA
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Zip | 15012-1513
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Country | US
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Telephone | 724-929-2550
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Fax | 724-929-5676
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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 | MD018219E
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License Number State | PA
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