Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 24200 | AZ |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 24200 | AZ |
NPI | 1033184486 |
---|---|
Provider Name | Dr. Kishore Tipirneni |
First Address | Phoenix, AZ 85027-4021 |
Second Address | Phoenix, AZ 85027-4021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
362872 | (05) | AZ |
3Z3942 | HEALTHNET (01) | AZ |