Basic Information
| Provider Information | |||||||||
| NPI: | 1356798938 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EPPERLY | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 475 BRUCE ST | ||||||||
| Address2: | |||||||||
| City: | YREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960973474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308412049 | ||||||||
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| Practice Location | |||||||||
| Address1: | 475 BRUCE STREET | ||||||||
| Address2: | FAIRCHILD MEDICAL CENTER | ||||||||
| City: | YREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960973474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308412049 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2016 | ||||||||
| LastUpdateDate: | 09/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 287761 | MA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | A151016 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.