Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1029 | AL |
N | 111NN0400X | Neurology | 1029 | AL |
N | 111NS0005X | Chiropractic Sports Physician | 1029 | AL |
NPI | 1396827366 |
---|---|
Provider Name | Dr. Judy A. Lipka |
First Address | Mobile, AL 36609-4210 |
Second Address | Mobile, AL 36609-4210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 04/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
515-10379 | BLUE CROSS BLUE SHIELD (01) | AL |
T68487 | (02) |