Provider Demographics
NPI:1760773436
Name:JEPPESEN, BRIAN MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:MATHEW
Last Name:JEPPESEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 B ST
Mailing Address - Street 2:SUITE 200, THE ALASKA HOSPITALIST GROUP
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5925
Mailing Address - Country:US
Mailing Address - Phone:907-375-3357
Mailing Address - Fax:
Practice Address - Street 1:4300 B ST
Practice Address - Street 2:SUITE 200, THE ALASKA HOSPITALIST GROUP
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-375-3357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK8055207R00000X
AK8154208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine