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General NPI Number Information
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NPI Number | 1780914713
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Entity Type | Organization
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Legal Business Name | EPPS MEDICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 01/14/2010
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 130 TIBET AVE SUITE 204
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City | SAVANNAH
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State | GA
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Zip | 31406-9028
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Country | US
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Telephone | 912-358-0231
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Fax | 912-358-0219
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Provider Business Mailing Address
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Address Line | 130 TIBET AVE SUITE 204
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City | SAVANNAH
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State | GA
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Zip | 31406-9028
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Country | US
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Telephone | 912-358-0231
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Fax | 912-358-0219
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. WILLIE D EPPS JR.
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Credential | DO
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Telephone | 912-358-0231
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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 | 57965
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License Number State | GA
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