Individual
BRUCE W KEPPEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 WILLMAR AVENUE SW, AFFILIATED COMMUNITY MEDICAL CENTERS, WILLMAR, MN 56201-3591
(320) 231-5079
(320) 231-5067
Mailing address
101 WILLMAR AVENUE SW, AFFILIATED COMMUNITY MEDICAL CENTERS, WILLMAR, MN 56201-3591
(320) 231-5079
(320) 231-5067
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2744
SD
207L00000X
Anesthesiology Physician
32303
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1198333
—
IA
01
—
30114
BLUE CROSS
IA
05
—
5700338
—
SD
Enumeration date
08/10/2005
Last updated
11/14/2011
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