Healthcare Provider Details
I. General information
NPI: 1871688598
Provider Name (Legal Business Name): SCOTT A RIPPLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/04/2006
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1606 N 7TH ST
TERRE HAUTE IN
47804-2706
US
IV. Provider business mailing address
6825 N COUNTY ROAD 425 W
BRAZIL IN
47834-7258
US
V. Phone/Fax
- Phone: 812-238-7000
- Fax: 812-238-7444
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 01041603A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 01041603A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: