Provider Demographics
NPI:1508922311
Name:JEPPE, WILLIAM GUY III (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GUY
Last Name:JEPPE
Suffix:III
Gender:M
Credentials:DC
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 931
Mailing Address - Street 2:
Mailing Address - City:MCCALL
Mailing Address - State:ID
Mailing Address - Zip Code:83638
Mailing Address - Country:US
Mailing Address - Phone:208-634-8271
Mailing Address - Fax:208-634-8271
Practice Address - Street 1:301 E PARK ST
Practice Address - Street 2:
Practice Address - City:MCCALL
Practice Address - State:ID
Practice Address - Zip Code:83638
Practice Address - Country:US
Practice Address - Phone:208-634-8271
Practice Address - Fax:208-634-8271
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010028703OtherREGENCE
IDC1773OtherBLUE CROSS
ID1674300Medicare ID - Type Unspecified