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General NPI Number Information
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NPI Number | 1861489080
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Entity Type | Organization
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Legal Business Name | KEITH M. LIPSMEYER, M.D.P.A.
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1711 N BUSINESS 9
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City | MORRILTON
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State | AR
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Zip | 72110-4507
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Country | US
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Telephone | 501-354-2456
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Fax | 501-354-2458
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Provider Business Mailing Address
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Address Line | PO BOX 677
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City | MORRILTON
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State | AR
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Zip | 72110-0677
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Country | US
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Telephone | 501-354-2456
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Fax | 501-354-2458
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH M LIPSMEYER
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Credential | M.D.
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Telephone | 501-354-2456
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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 | C-5214
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License Number State | AR
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