Provider Demographics
NPI:1386273472
Name:EPPS, MICHAEL RAY JR (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:RAY
Last Name:EPPS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1400 US HIGHWAY 1 S
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-4211
Mailing Address - Country:US
Mailing Address - Phone:904-829-2286
Mailing Address - Fax:
Practice Address - Street 1:1400 US HIGHWAY 1 S
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-4211
Practice Address - Country:US
Practice Address - Phone:904-829-2286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS21207207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology