Provider Demographics
NPI:1811938285
Name:SEPPI, DAVID KURT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KURT
Last Name:SEPPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 ADDISON AVE W
Mailing Address - Street 2:SUITE100
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5491
Mailing Address - Country:US
Mailing Address - Phone:208-733-4343
Mailing Address - Fax:208-734-9941
Practice Address - Street 1:630 ADDISON AVE W
Practice Address - Street 2:SUITE100
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5491
Practice Address - Country:US
Practice Address - Phone:208-733-4343
Practice Address - Fax:208-734-9941
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM4501207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00431122OtherRR MEDICARE
IDP00431122OtherRR MEDICARE
ID1117144Medicare ID - Type UnspecifiedMEDICARE NUMBER