Provider Demographics
NPI:1689777815
Name:EPPLE, LENORA MAE (DO)
Entity type:Individual
Prefix:DR
First Name:LENORA
Middle Name:MAE
Last Name:EPPLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 FOXFIRE LN
Mailing Address - Street 2:
Mailing Address - City:LOHMAN
Mailing Address - State:MO
Mailing Address - Zip Code:65053-9602
Mailing Address - Country:US
Mailing Address - Phone:573-289-9619
Mailing Address - Fax:
Practice Address - Street 1:1705 CHRISTY DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-5195
Practice Address - Country:US
Practice Address - Phone:573-289-9619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008003780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00713887OtherRAILROAD MEDICARE
MO1689777815Medicaid
MO431560263OtherTRICARE WEST
MO132300025Medicare PIN
MO1689777815Medicaid