MEDICARE: DR. ANNETTE RHODA PEPPARD AU. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	AUD001218	GA
2	237600000X	Audiologist-Hearing Aid Fitter	AUD001218	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093710196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNETTE RHODA PEPPARD AU. D.

Provider Business Mailing Address
First Line	:	302 MARGIE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-7817
Country	:	US
Telephone Number	:	478-953-2705
Fax Number	:	478-953-2857

Provider Business Practice Location Address
First Line	:	302 MARGIE DR
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-7817
Country	:	US
Telephone Number	:	478-953-2705
Fax Number	:	478-953-2857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	11/12/2009

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