Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 000361 | MO |
NPI | 1316941172 |
---|---|
Provider Name | Dr. Phillip Anthony Lipira |
First Address | Saint Joseph, MO 64506-2989 |
Second Address | Saint Joseph, MO 64506-2989 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 07/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04529022 | BC/BS OF KC (01) | MO |
P000062470 | PALMETTO GBA (01) | MO |
T42460 | (02) | MO |