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General NPI Number Information
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NPI Number | 1346552932
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Entity Type | Individual
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Provider Name | ROBERT LANE TIPPENS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 205 MILLER SPRINGS COURT ATTN: CBO
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City | FRANKLIN
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State | TN
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Zip | 37064-5434
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Country | US
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Telephone | 931-528-9499
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 FLEET GUARD RD
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City | COOKEVILLE
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State | TN
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Zip | 38506
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Country | US
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Telephone | 931-528-9499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000014803
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License Number State | TN
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