DAVID KEPHART JR. (NPI# 1376906958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376906958 |
| Entity Type | Individual |
| Full Name | DAVID KEPHART JR. |
| Credential | D.O. |
| Practice Address |
1100 Wilford Hall Loop Bldg 4454 Jbsa Lackland TX 78236 |
| Mailing Address |
1100 Wilford Hall Loop Bldg 4554 Jbsa Lackland TX 78236-5638 |
| Practice Telephone | 2109163290 |
| Mailing Telephone | 2109163290 |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2018-08-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | C2-0012271 | DE | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3551 Roger Brooke Dr, Fort Sam Houston, TX 782344504 | 2109163808 | |
| 501 W 14th St, Wilmington, DE 198011013 | 3027331000 |
| Street Address |
1100 WILFORD HALL LOOP BLDG 4454 |
| City | JBSA LACKLAND |
| State | TX |
| Zip Code | 78236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| 1700284916 | Jeffery Scott Martin | Psychologist | 1025 Femoyer St Bldg 10908, Jbsa Lackland, TX 78236 | 2014-12-22 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447748736 | Rainel Zelaya | General Practice | 1100 Wilford Hall Loop, Building 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-4504 | 2018-04-23 |
| 1073172565 | Robert A Kowtoniuk | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-06-10 |
| 1083170252 | Kristen Garvie | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2019-02-13 |
| 1700379047 | Lauren Wilson Love | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236 | 2018-06-12 |
| 1386136299 | Lindsay Erin Gilmore | General Practice | 1100 Wilford Hall Loop Bldg 455459, Jbsa Lackland, TX 78236-5638 | 2018-06-06 |
| 1063919819 | Julie Marie Fischer | General Practice | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2018-04-09 |
| 1780188615 | Ashley Elizabeth Sam | General Practice | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Bldg 4554, 59 Mdw/gme, Jbsa Lackland, TX 78236-9908 | 2018-03-23 |
| 1396247367 | Auston Douglas Eckert | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2018-03-06 |
| 1003317744 | Heidi Dearborn | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2018-02-27 |
| 1275067746 | Courtney Clutter | General Practice | 1100 Wilford Hall Loop, Jbsa Lackland, TX 78236-5638 | 2017-04-12 |
| Find all providers in JBSA LACKLAND | ||||
| City | JBSA LACKLAND |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on DAVID KEPHART JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.