Provider Demographics
NPI:1184605966
Name:EPPERSON, THOMAS N III (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:N
Last Name:EPPERSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 CUMBERLAND AVE
Mailing Address - Street 2:MEDICAL ARTS BLDY
Mailing Address - City:MIDDLESBORO
Mailing Address - State:KY
Mailing Address - Zip Code:40965-2343
Mailing Address - Country:US
Mailing Address - Phone:606-248-3324
Mailing Address - Fax:606-248-8960
Practice Address - Street 1:3004 CUMBERLAND AVE
Practice Address - Street 2:MEDICAL ARTS BLDG
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2343
Practice Address - Country:US
Practice Address - Phone:606-248-3324
Practice Address - Fax:606-248-8960
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31838207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64318389Medicaid
KY000000051294OtherBLUE CROSS BLUE SHIELD
KY000000051294OtherBLUE CROSS BLUE SHIELD
KY64318389Medicaid