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NPI Code Detail

MEDICARE: DR. HEATHER ROSS TIPSWORD D.O.

MEDICARE:  DR. HEATHER ROSS TIPSWORD  D.O.
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
1207Q00000XFamily Medicine Physician3988OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902804248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER ROSS TIPSWORD D.O.
Provider Business Mailing Address
First Line : 2514 NORTH MERIDIAN AVENUE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-1035
Country : US
Telephone Number : 405-722-1110
Fax Number : 405-721-8263
Provider Business Practice Location Address
First Line : 3601 SW 160TH AVE
Second Line : SUITE 250
City : MIRAMAR
State : FL
Zip : 33027-6308
Country : US
Telephone Number : 954-399-4621
Fax Number : 877-892-9770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 10/03/2011

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Directions to “ DR. HEATHER ROSS TIPSWORD D.O.” Practice Location

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