Healthcare Provider Details

I. General information

NPI: 1295477743
Provider Name (Legal Business Name): CONNER THOMAS LIPIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N MONROE ST STE 800
TALLAHASSEE FL
32301-1500
US

IV. Provider business mailing address

101 N MONROE ST SUITE 800, PRIVATE OFFICE 860
TALLAHASSEE FL
32301-1549
US

V. Phone/Fax

Practice location:
  • Phone: 833-351-8255
  • Fax:
Mailing address:
  • Phone: 833-351-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number113255
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number23655
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number343562
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: