Provider Demographics
NPI:1851392245
Name:EPLEY, JOHN MARTIN JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARTIN
Last Name:EPLEY
Suffix:JR
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 1:125 SOUTH JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3424
Mailing Address - Country:US
Mailing Address - Phone:931-526-7581
Mailing Address - Fax:931-526-7211
Practice Address - Street 1:125 SOUTH JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3424
Practice Address - Country:US
Practice Address - Phone:931-526-7581
Practice Address - Fax:931-526-7211
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD012901207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3014606Medicaid
012901OtherMEDICAL #
012901OtherMEDICAL #
D45289Medicare UPIN
012901OtherMEDICAL #