Provider Demographics
NPI:1962285502
Name:EPLETT AND ASSOCIATES
Entity type:Organization
Organization Name:EPLETT AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:EPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:DL
Authorized Official - Phone:458-215-5806
Mailing Address - Street 1:720 BENNETT AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6722
Mailing Address - Country:US
Mailing Address - Phone:458-215-5806
Mailing Address - Fax:
Practice Address - Street 1:720 BENNETT AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6722
Practice Address - Country:US
Practice Address - Phone:458-215-5806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental