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NPI Code Detail

MEDICARE: DR. WILLIAM KENNEY GEPHART PHARM.D.

MEDICARE: DR. WILLIAM KENNEY GEPHART PHARM.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
1183500000XPharmacistRPH32273CA

General Provider Information

NPI Number : 1619253176
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM KENNEY GEPHART PHARM.D.
Provider Business Mailing Address
First Line : 264 YACHTSMAN DR
Second Line :
City : VALLEJO
State : CA
Zip : 94591-7729
Country : US
Telephone Number : 707-553-8909
Fax Number :
Provider Business Practice Location Address
First Line : 2100 PEABODY RD
Second Line :
City : VACAVILLE
State : CA
Zip : 95687-6639
Country : US
Telephone Number : 707-451-0182
Fax Number : 707-454-3400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2011
Last Update Date : 10/28/2011

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