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Contact Information

WILLIS H KEPHART, MD
4705 MONTGOMERY BLVD NE
STE 301
ALBUQUERQUE, NM87109-1226
 Phone: 505-727-4500
 Fax: 505-727-4505
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for WILLIS H KEPHART · (Male)

NPI Number 1306872940
Status Active
Credentials MD
Entity Individual
Enumeration date 06/24/2006
Last updated 08/10/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2000165660
  • NM License # 81-243
  • KS Medicaid 100327540B
  • KS Medicaid 90036022
  • MO Medicaid 010568509
  • MO Medicaid 205083603
  • MO Medicaid 540568508
  • MO Medicaid 595956103
  • MO Medicaid 595956202
  • MO Medicaid 595956400
  • MO Medicaid 595985805
  • MO Medicaid 599225901
  • NM Medicaid 32771
  • OK Medicaid 100188410A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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