| Kephartsportsmedicine Llc | |
|
403 Hyde Park Doylestown PA 18902-6619 | |
| (267) 406-4083 | |
| (267) 406-4659 |
| Full Name | Kephartsportsmedicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 403 Hyde Park, Doylestown, Pennsylvania |
| Authorized Official Name and Position | Eric M Kephart (OWNER) |
| Authorized Official Contact | 2679801864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kephartsportsmedicine Llc 403 Hyde Park Doylestown PA 18902-6619 Ph: (267) 406-4083 | Kephartsportsmedicine Llc 403 Hyde Park Doylestown PA 18902-6619 Ph: (267) 406-4083 |
| NPI Number | 1598400392 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Medicare PECOS PAC ID | 3678952116 |
|---|---|
| Medicare Enrollment ID | O20220614000929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598400392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric M Kephart |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1104913680 PECOS PAC ID: 5799837167 Enrollment ID: I20090715000568 |
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