MEDICARE: R FLIPPIN SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DG2799	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	09932334	OTHER	IL	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356372866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R FLIPPIN SC

Provider Business Mailing Address
First Line	:	PO BOX 16557
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-0557
Country	:	US
Telephone Number	:	414-444-9242
Fax Number	:	414-444-9252

Provider Business Practice Location Address
First Line	:	3915 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2528
Country	:	US
Telephone Number	:	414-444-9242
Fax Number	:	414-444-9252

Authorized Official
Title or Position	:	PRESIDENT
Name	:	REGINA FLIPPIN
Credential	:	DPM
Telephone Number	:	414-444-9242

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/26/2011

Similar Medicare Providers

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Practice Location Address:

3915 W CAPITOL DR
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1104925965 — DR. PAMELA WILSON HUMES DPM
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1932265469 — URBAN FOOT CARE SURGICAL CENTER LLC
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1790005973 — JEFFREY T. FOLLANSBEE, M.D., S.C.
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1619374584 — MIDWEST FOOT & ANKLE SPECIALISTS
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1730586561 — MIDWEST FOOT & ANKLE SURGICAL CENTER
Practice Location Address:

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Directions to “R FLIPPIN SC ” Practice Location

Language	Start Address	Practice Location

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