Basic Information
Provider Information
NPI: 1942239322
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEPNER
FirstName: ANDREW
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1803 MOUNT ROSE AVE
Address2: STE B3
City: YORK
State: PA
PostalCode: 174033026
CountryCode: US
TelephoneNumber: 7178511405
FaxNumber: 7178516969
Practice Location
Address1: 1001 S GEORGE ST
Address2: YORK HOSPITAL EMERGENCY DEPARTMENT
City: YORK
State: PA
PostalCode: 174033676
CountryCode: US
TelephoneNumber: 7178512450
FaxNumber: 7178513469
Other Information
ProviderEnumerationDate: 06/30/2006
LastUpdateDate: 10/29/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XMD417319PAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
154707001PAGATEWAY-YHOTHER
10099801PAGEISINGER-YHOTHER
5006722701PACAPITAL BLUE CROSS-YHOTHER
229362400001PAAMERIHEALTH 65 PA-YHOTHER
161465801PAHIGHMARK BLUE SHIELD-YHOTHER
2003841101PAAMERIHEALTH MERCY-YHOTHER


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