Provider Demographics
NPI:1730181009
Name:CEPELA, MARK A (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:CEPELA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-581-7120
Mailing Address - Fax:859-581-7207
Practice Address - Street 1:2865 CHANCELLOR DR
Practice Address - Street 2:STE 210
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3931
Practice Address - Country:US
Practice Address - Phone:859-331-6616
Practice Address - Fax:859-331-5760
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-04-04
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Provider Licenses
StateLicense IDTaxonomies
KY27950207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0847561Medicaid
OHH192101OtherMEDICARE PIN
KY64279508Medicaid
IN100374230Medicaid
180034766OtherMEDICARE RAILROAD
OH4080443Medicare PIN
OH0693708Medicare PIN
IN100374230Medicaid
OHH192100Medicare PIN
OH4080442Medicare PIN
KY0516101Medicare PIN