MEDICARE: NANCY P. LIPSON 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
1	208100000X	Physical Medicine & Rehabilitation Physician	01037236A	IN
2	208100000X	Physical Medicine & Rehabilitation Physician	48401	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245214188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY P. LIPSON M.D.

Provider Business Mailing Address
First Line	:	2102 N. COUNTRY CLUB, BLDG. B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716
Country	:	US
Telephone Number	:	520-795-8371
Fax Number	:	520-320-3808

Provider Business Practice Location Address
First Line	:	2102 N. COUNTRY CLUB, BLDG. B
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716
Country	:	US
Telephone Number	:	520-795-8371
Fax Number	:	520-320-3808

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/09/2014

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