Provider Demographics
NPI:1588925762
Name:EPPLEY, THOMAS BENTON III (PA-C)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BENTON
Last Name:EPPLEY
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1061 HARMON AVE
Mailing Address - Street 2:1D03
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-6965
Mailing Address - Fax:
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:1D03
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2024-03-04
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical