Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 053880 | GA |
N | 207YP0228X | Pediatric Otolaryngology | 228289 | MA |
NPI | 1497886428 |
---|---|
Provider Name | Dr. James Andrew Sipp |
First Address | Atlanta, GA 30342-3009 |
Second Address | Atlanta, GA 30342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 11/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
519401643 | (05) | GA |