Provider Demographics
NPI:1104129584
Name:JOHN M LEPI MD INC
Entity type:Organization
Organization Name:JOHN M LEPI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MGR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-452-6778
Mailing Address - Street 1:945 BETHESDA DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0801
Mailing Address - Country:US
Mailing Address - Phone:740-452-6778
Mailing Address - Fax:740-252-3246
Practice Address - Street 1:945 BETHESDA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0801
Practice Address - Country:US
Practice Address - Phone:740-452-6778
Practice Address - Fax:740-252-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062044207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0893387Medicaid
OKLE0761591Medicare PIN
OHF79956Medicare UPIN