Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 45629 | CO |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 45629 | CO |
NPI | 1518934678 |
---|---|
Provider Name | Eric K Jepson |
First Address | Colorado Springs, CO 80920-7835 |
Second Address | Colorado Springs, CO 80920-7835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 15/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
96457821 | (05) | CO |