Provider Demographics
NPI:1730177353
Name:KEPPEL, LOWELL H (MD)
Entity type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:H
Last Name:KEPPEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15225 WOODBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3645
Mailing Address - Country:US
Mailing Address - Phone:262-785-9445
Mailing Address - Fax:
Practice Address - Street 1:225 S EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4266
Practice Address - Country:US
Practice Address - Phone:262-814-3692
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27402-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIAK8761113OtherDEA NUMBER