Provider Demographics
NPI:1518947423
Name:EPPS, LORNETTA TAYLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:LORNETTA
Middle Name:TAYLOR
Last Name:EPPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 N E ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-6339
Mailing Address - Country:US
Mailing Address - Phone:850-912-6550
Mailing Address - Fax:850-912-6554
Practice Address - Street 1:1717 N E ST
Practice Address - Street 2:SUITE 401
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-6339
Practice Address - Country:US
Practice Address - Phone:850-912-6550
Practice Address - Fax:850-912-6554
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11575208D00000X
FLME47561207V00000X
MI4301042005208D00000X
FL47561208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03860OtherBLUE CROSS BLUE SHIELD FL
FLZ101OtherHEALTHEASE
FLZ101OtherHEALTH OPTIONS
FL160055557OtherRAILROAD MEDICARE
FLZ101OtherWELLCARE
AL59167045OtherBLUE CROSS BLUE SHIELD AL
FLZ101OtherHEALTHY KIDS
FL264811300Medicaid
FLZ101OtherVISTA
FLZ101OtherHEALTHEASE
FL03860WMedicare ID - Type Unspecified