1801118492 NPI number — BRIAN KEPLINGER, O.D., PSC

Table of content: CHRISTOPHER MCMULLEN MA, LPC (NPI 1063801785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801118492 NPI number — BRIAN KEPLINGER, O.D., PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIAN KEPLINGER, O.D., PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801118492
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 GRANDVIEW DR
Provider Second Line Business Mailing Address:
SUITE F
Provider Business Mailing Address City Name:
FRANKFORT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40601-3235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-695-1771
Provider Business Mailing Address Fax Number:
502-695-1448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 GRANDVIEW DR
Provider Second Line Business Practice Location Address:
SUITE F
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-3235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-695-1771
Provider Business Practice Location Address Fax Number:
502-695-1448
Provider Enumeration Date:
02/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KEPLINGER
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
LEIGH
Authorized Official Title or Position:
PRESIDENT/ OPTOMETRIST
Authorized Official Telephone Number:
502-695-1771

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  1484-DT , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000287821 . This is a "ANTHEM BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7404229 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 77000339 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2200221 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 383697423 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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