Provider Demographics
NPI:1518957372
Name:EPPS, DOUGLAS K (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:K
Last Name:EPPS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1050 EAGLES LANDING PKWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9018
Mailing Address - Country:US
Mailing Address - Phone:770-389-9494
Mailing Address - Fax:770-357-2511
Practice Address - Street 1:1050 EAGLES LANDING PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9018
Practice Address - Country:US
Practice Address - Phone:770-389-9494
Practice Address - Fax:770-357-2511
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA48349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA185263247AMedicaid
GA10033141OtherAMERIGROUP
GA1518957372OtherBC/BS GEORGIA
GA314126OtherWELLCARE
GAP00172081OtherRAILROAD MEDICARE
GA185263247AMedicaid
GAH98476Medicare UPIN