Shepperson, Kyle

Shepperson, Kyle is an individual health care provider with primary practice located at 6810 State Route 162 Suite 10, Maryville IL 62062. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Shepperson, Kyle can be contacted via phone (618) 288-2020.

Contact Information

Primary practice address
6810 State Route 162 Suite 10 Maryville IL 62062
Phone: (618) 288-2020
Fax: (618) 288-7983
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036108702 Illinois

Profile Details

NPI number 1407831704
LBN Legal business name Shepperson, Kyle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Mar 17th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407831704 NPPES
Illinois MEDICAID 036108702

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