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General NPI Number Information
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NPI Number | 1699708271
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Entity Type | Individual
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Provider Name | RANDOLPH B LIPSCHER MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 1110 W WILLIAM CANNON DR STE 404
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City | AUSTIN
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State | TX
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Zip | 78745-5498
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Country | US
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Telephone | 512-377-9904
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Fax | 512-717-9036
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Provider Business Mailing Address
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Address Line | 530 NE GLEN OAK AVE
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City | PEORIA
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State | IL
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Zip | 61637-0001
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Country | US
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Telephone | 309-655-2553
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Fax | 309-655-2602
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 67740
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101278138
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | J9904
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 62091
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 43172
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD50106
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License Number State | IA
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Taxonomy #7
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number | J9904
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036146670
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License Number State | IL
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