Provider Demographics
NPI:1043226897
Name:LEPEJIAN, GARINE (MD)
Entity Type:Individual
Prefix:
First Name:GARINE
Middle Name:
Last Name:LEPEJIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BRAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024-3158
Mailing Address - Country:US
Mailing Address - Phone:731-285-4111
Mailing Address - Fax:731-285-4221
Practice Address - Street 1:1501 BRAYTON AVE
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024-3158
Practice Address - Country:US
Practice Address - Phone:731-285-4111
Practice Address - Fax:731-285-4221
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000040876174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist