Provider Demographics
NPI:1851440267
Name:EPPERSON, DENISE L (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:L
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7212 OLD HEADY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-5214
Mailing Address - Country:US
Mailing Address - Phone:502-261-1605
Mailing Address - Fax:
Practice Address - Street 1:10331 CHAMPION FARMS DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6129
Practice Address - Country:US
Practice Address - Phone:503-975-2960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038239A2084P0800X
KY251822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64251820Medicaid
INCG3623OtherPV RR MEDICARE GROUP
INP00453459OtherRAILROAD MEDICARE
IN100386460OtherPV MEDICAID GROUP
000000056294OtherANTHEM GROUP
KY65927857OtherPV MEDICAID GROUP
IN160780OtherPV MEDICARE GROUP
INCG3623OtherPV RR MEDICARE GROUP
IN160780DDMedicare PIN