Provider Demographics
NPI:1518426543
Name:CULPEPPER, KALEB LOGAN (DO)
Entity Type:Individual
Prefix:DR
First Name:KALEB
Middle Name:LOGAN
Last Name:CULPEPPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13067 N TELECOM PKWY FL 33637
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-0926
Mailing Address - Country:US
Mailing Address - Phone:813-469-1872
Mailing Address - Fax:786-868-0012
Practice Address - Street 1:13067 N TELECOM PKWY FL 33637
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-0926
Practice Address - Country:US
Practice Address - Phone:813-469-1872
Practice Address - Fax:786-868-0012
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS205982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program