MEDICARE: DR. WILLIAM K KEPHART MD

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	207L00000X	Anesthesiology Physician	9700612	NC
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	9700612	NC

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

General Provider Information

NPI Number	:	1689653818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM K KEPHART MD

Provider Business Mailing Address
First Line	:	PO BOX 1832
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27216-1832
Country	:	US
Telephone Number	:	336-585-1770
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 HUFFMAN MILL RD
Second Line	:	STE 2000
City	:	BURLINGTON
State	:	NC
Zip	:	27215-8700
Country	:	US
Telephone Number	:	336-585-1770
Fax Number	:

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	10/08/2007

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Directions to “ DR. WILLIAM K KEPHART MD” Practice Location

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