Healthcare Provider Details

I. General information

NPI: 1801930896
Provider Name (Legal Business Name): JOSEPH A CIPPEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 MAIN ST
ELDERTON PA
15736
US

IV. Provider business mailing address

PO BOX 579
KITTANNING PA
16201-0579
US

V. Phone/Fax

Practice location:
  • Phone: 724-354-5258
  • Fax: 724-354-4396
Mailing address:
  • Phone: 724-543-8164
  • Fax: 724-543-8616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD057764L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: