Provider Demographics
NPI:1821051699
Name:EPTER, JACK L (DC)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:L
Last Name:EPTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W INDIANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3530
Mailing Address - Country:US
Mailing Address - Phone:561-575-4400
Mailing Address - Fax:561-427-0026
Practice Address - Street 1:100 W INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-3530
Practice Address - Country:US
Practice Address - Phone:561-575-4400
Practice Address - Fax:561-427-0026
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004296111NN1001X, 111NS0005X
NYX3467111NN1001X, 111NS0005X
NC3443111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1186957OtherACN
FL592895303OtherTRIAD/OXFORD
FL1026594OtherAMERICAN HEALTH SPECIALTY
FL59084110OtherBLUE CROSS BLUE SHIELD AL
FL592895303OtherPHCS
FL592895303OtherFOCUS HEALTCARE NETWORK
FL592895303OtherHEALTHCARE NETWORKS OF AM
FL22326OtherBLUE CROSS BLUE SHIELD FL
FL11115063OtherMULTIPLAN
FL592895303OtherUNITEDHEALTHCARE
FL3500020270OtherRAILROAD MEDICARE
FL592895303OtherUNITEDHEALTHCARE
FL592895303OtherHEALTHCARE NETWORKS OF AM