Basic Information
Provider Information
NPI: 1912948498
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EPPS JR.
FirstName: WILLIAM
MiddleName: BURTON
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3239
Address2:  
City: FLORENCE
State: SC
PostalCode: 295023239
CountryCode: US
TelephoneNumber: 8437777162
FaxNumber: 8437777102
Practice Location
Address1: 115 N SUMTER ST
Address2: SUITE 410
City: SUMTER
State: SC
PostalCode: 291504972
CountryCode: US
TelephoneNumber: 8038835171
FaxNumber: 8038835174
Other Information
ProviderEnumerationDate: 06/08/2006
LastUpdateDate: 05/18/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X6993SCY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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