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NPI Code Detail

MEDICARE: JEFFREY ALAN WIPFLI M.D.

MEDICARE: JEFFREY ALAN WIPFLI M.D.
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
1207W00000XOphthalmology Physician105244FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
27121145OTHERFLAETNA
31460POTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093718058
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY ALAN WIPFLI M.D.
Provider Business Mailing Address
First Line : 43309 US HIGHWAY 19 N
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-6221
Country : US
Telephone Number : 727-938-2020
Fax Number : 727-943-3334
Provider Business Practice Location Address
First Line : 43309 US HIGHWAY 19 N
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-6221
Country : US
Telephone Number : 727-938-2020
Fax Number : 727-943-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 11/25/2013

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