Provider Demographics
NPI:1679589980
Name:SHEPLAY, ANTHONY WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:SHEPLAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1105 LAS TABLAS RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-9731
Mailing Address - Country:US
Mailing Address - Phone:805-434-0781
Mailing Address - Fax:805-434-0489
Practice Address - Street 1:1105 LAS TABLAS RD
Practice Address - Street 2:SUITE D
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-9731
Practice Address - Country:US
Practice Address - Phone:805-434-0781
Practice Address - Fax:805-434-0489
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG 619752081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE80482Medicare UPIN