Provider Demographics
NPI:1184687311
Name:KEPLINGER, LYNN EVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:EVETTE
Last Name:KEPLINGER
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:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-882-2259
Mailing Address - Fax:
Practice Address - Street 1:101 S FAIRVIEW ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201
Practice Address - Country:US
Practice Address - Phone:573-882-4464
Practice Address - Fax:573-884-8142
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300183207R00000X
MO2007016203207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205477607Medicaid
MOP00430567Medicare PIN
F58913Medicare UPIN
MO205477607Medicaid