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General NPI Number Information
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NPI Number | 1598400392
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Entity Type | Organization
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Legal Business Name | KEPHARTSPORTSMEDICINE LLC
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 403 HYDE PARK
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City | DOYLESTOWN
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State | PA
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Zip | 18902-6619
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Country | US
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Telephone | 267-406-4083
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Fax | 267-406-4659
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Provider Business Mailing Address
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Address Line | 403 HYDE PARK
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City | DOYLESTOWN
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State | PA
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Zip | 18902-6619
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Country | US
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Telephone | 267-406-4083
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Fax | 267-406-4659
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Authorized Official
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Title or Position | OWNER
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Name | ERIC M KEPHART
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Credential | DO
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Telephone | 267-980-1864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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