Provider Demographics
NPI:1891952693
Name:HEPLER, TAGG (MPA, PA)
Entity Type:Individual
Prefix:
First Name:TAGG
Middle Name:
Last Name:HEPLER
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Gender:M
Credentials:MPA, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9381
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:6000 BROOKTREE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9279
Practice Address - Country:US
Practice Address - Phone:724-933-9110
Practice Address - Fax:724-933-9111
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051282363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant