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General NPI Number Information
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NPI Number | 1528215779
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Entity Type | Organization
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Legal Business Name | LARRY J. KIPP DPM, PA
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Dates
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Enumeration Date | 08/19/2008
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 5145 DEER PARK DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-7013
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Country | US
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Telephone | 727-868-2128
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Fax | 727-868-7491
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Provider Business Mailing Address
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Address Line | 5145 DEER PARK DR
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-7013
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Country | US
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Telephone | 727-809-1555
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Fax | 727-843-8033
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY J KIPP
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Credential |
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Telephone | 727-868-2128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P0000655
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License Number State | FL
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