Provider Demographics
NPI:1902832504
Name:EPPS, WILLIE D JR (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIE
Middle Name:D
Last Name:EPPS
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:130 STEPHENSON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5899
Mailing Address - Country:US
Mailing Address - Phone:912-358-0231
Mailing Address - Fax:912-358-0236
Practice Address - Street 1:130 STEPHENSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5899
Practice Address - Country:US
Practice Address - Phone:912-358-0231
Practice Address - Fax:912-358-0236
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA57965207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA504598094CMedicaid
582203199-004OtherTRICARE-URGENTONE-SAVANNAH
SCG57965Medicaid
GA52210441-001OtherBCBS-URGENTONE-SAVANNAH
GA504598094DMedicaid
GA52210441-002OtherBCBS-URGENTONE-POOLER
582203199-009OtherTRICARE-URGENTONE-POOLER
GAP00394395OtherRR MEDICARE
582203199-009OtherTRICARE-URGENTONE-POOLER
GA08CBCMGMedicare PIN