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General NPI Number Information
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NPI Number | 1588949200
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Entity Type | Organization
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Legal Business Name | JEFFREY A. LIPKE, MD PC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 3 TEN MILE DRIVE
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City | GRANBY
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State | CO
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Zip | 80446
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Country | US
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Telephone | 970-531-7026
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Fax |
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Provider Business Mailing Address
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Address Line | 215 E LAKE ST
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City | OSAKIS
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State | MN
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Zip | 56360-8266
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Country | US
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Telephone | 970-531-7026
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JEFFREY ALLEN LIPKE
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Credential | M.D.
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Telephone | 970-531-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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