Healthcare Provider Details

I. General information

NPI: 1871571224
Provider Name (Legal Business Name): RICHARD R RIPPERGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date: 05/24/2018
Reactivation Date: 07/10/2018

III. Provider practice location address

27005 GLYNNS CREEK CT
ELDRIDGE IA
52748
US

IV. Provider business mailing address

27005 GLYNNS CREEK CT
ELDRIDGE IA
52748-9405
US

V. Phone/Fax

Practice location:
  • Phone: 563-320-4756
  • Fax:
Mailing address:
  • Phone: 563-320-4756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD-20699
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD-20699
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: