Provider Demographics
NPI:1588419923
Name:KEPHART, CORY JAMES
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:JAMES
Last Name:KEPHART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALLEGHENY GENERAL HOSPITAL
Mailing Address - Street 2:320 EAST NORTH AVENUE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212
Mailing Address - Country:US
Mailing Address - Phone:412-359-3269
Mailing Address - Fax:
Practice Address - Street 1:ALLEGHENY GENERAL HOSPITAL
Practice Address - Street 2:320 EAST NORTH AVENUE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212
Practice Address - Country:US
Practice Address - Phone:412-359-3269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program