Provider Demographics
NPI:1588648976
Name:LEPLEY, BRIAN KENNETH (DO)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:KENNETH
Last Name:LEPLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:809 SW 89TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9300
Mailing Address - Country:US
Mailing Address - Phone:405-631-4000
Mailing Address - Fax:405-631-4404
Practice Address - Street 1:809 SW 89TH ST
Practice Address - Street 2:STE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9300
Practice Address - Country:US
Practice Address - Phone:405-631-4000
Practice Address - Fax:405-631-4404
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-30
Last Update Date:2007-08-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100175560AMedicaid
OK1202247OtherPERSCRIBER NUMBER
F54937Medicare UPIN