Provider Demographics
NPI:1073616355
Name:EPLING, KIMBERLY KAY (OD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:KAY
Last Name:EPLING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2841 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3009
Mailing Address - Country:US
Mailing Address - Phone:606-324-2451
Mailing Address - Fax:606-324-7123
Practice Address - Street 1:2841 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-3009
Practice Address - Country:US
Practice Address - Phone:606-324-2451
Practice Address - Fax:606-324-7123
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV986-OD152W00000X
OH5366 T2277152W00000X
KY1798DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVU81588Medicare UPIN