Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | MD041136E | PA |
NPI | 1174599005 |
---|---|
Provider Name | Dr. Paul D Tippet |
First Address | Wexford, PA 15090-9282 |
Second Address | Wexford, PA 15090-9282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 30/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
322194 | (05) | PA |
B41546 | (02) | PA |