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Individual

KENNETH N KEPHART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2615 EAST FRANKLIN AVENUE, MINNEAPOLIS, MN 55406
(612) 333-0770
Mailing address
420 DELAWARE ST SE, UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 333-0770

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
26265
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-04725
MEDICA-PRIMARY
MN
01
032003
FAIRVEW
MN
01
0628004
PREFERRED ONE
MN
01
100544
U CARE
MN
01
32G78KE
BCBS
MN
01
934694
ARAZID
01
HP16524
HEALTH PARTNERS
MN
Enumeration date
10/11/2006
Last updated
07/08/2007
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