Provider Demographics
NPI:1184151623
Name:KEPPLINGER, ANDREW JOHN (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:KEPPLINGER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3612 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5507
Mailing Address - Country:US
Mailing Address - Phone:269-599-4701
Mailing Address - Fax:
Practice Address - Street 1:8300 WESTPARK WAY
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-7901
Practice Address - Country:US
Practice Address - Phone:616-748-5788
Practice Address - Fax:616-748-5787
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5307009420207R00000X
390200000X
MI5101025781208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program