Provider Demographics
NPI:1447232715
Name:EPPERLY, NEIL A (DO)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:A
Last Name:EPPERLY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1350 WALTON WAY
Mailing Address - Street 2:3RD FL, CRITICAL CARE MEDICINE
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2612
Mailing Address - Country:US
Mailing Address - Phone:706-774-5713
Mailing Address - Fax:706-774-5789
Practice Address - Street 1:1350 WALTON WAY
Practice Address - Street 2:3RD FL, CRITICAL CARE MEDICINE
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2612
Practice Address - Country:US
Practice Address - Phone:706-774-5713
Practice Address - Fax:706-774-5789
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA040055207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000666971CMedicaid
NC5910662Medicaid
SCG40055Medicaid
NC5910662Medicaid
G11971Medicare UPIN
GA000666971CMedicaid