MEDICARE: DR. JEFFREY ALLEN LIPKE M.D.

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	207Q00000X	Family Medicine Physician	63357	MN
2	207Q00000X	Family Medicine Physician	38021	CO
3	207Q00000X	Family Medicine Physician	44135	AL

General Provider Information

NPI Number	:	1508827858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY ALLEN LIPKE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3634
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-7634
Country	:	US
Telephone Number	:	251-974-2273
Fax Number	:	251-974-2276

Provider Business Practice Location Address
First Line	:	4223 ORANGE BEACH BLVD STE C
Second Line	:
City	:	ORANGE BEACH
State	:	AL
Zip	:	36561-3460
Country	:	US
Telephone Number	:	251-974-2273
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/08/2022

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