Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS13164 | PA |
NPI | 1003010133 |
---|---|
Provider Name | Jon David Lepley |
First Address | Lancaster, PA 17602 |
Second Address | Lancaster, PA 17602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 01/04/2021 |