MEDICARE: MRS. HILLARY LYNN TIPTON PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363AS0400X	Surgical Physician Assistant	PA109036	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WQ765	OTHER	FL	HFMG
2	WQ766	OTHER	FL	HFPS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053796227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HILLARY LYNN TIPTON PA-C

Provider Business Mailing Address
First Line	:	2081 COLONIAL CIR
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37803-2678
Country	:	US
Telephone Number	:	865-661-8513
Fax Number	:

Provider Business Practice Location Address
First Line	:	2081 COLONIAL CIR
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37803-2678
Country	:	US
Telephone Number	:	865-661-8513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2015
Last Update Date	:	12/29/2025

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