Provider Demographics
NPI:1982051298
Name:REPER, LOUIS I II (DPM)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:I
Last Name:REPER
Suffix:II
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 TOWN CREEK RD E STE 3
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5690
Mailing Address - Country:US
Mailing Address - Phone:865-986-2700
Mailing Address - Fax:
Practice Address - Street 1:125 TOWN CREEK RD E STE 3
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772
Practice Address - Country:US
Practice Address - Phone:407-491-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM0000000850213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery