MEDICARE: DR. DARREN LEE TIPTON D.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	111N00000X	Chiropractor	3441	OK

General Provider Information

NPI Number	:	1245274760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN LEE TIPTON D.C.

Provider Business Mailing Address
First Line	:	4940 S UNION AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74107-7840
Country	:	US
Telephone Number	:	918-447-6867
Fax Number	:	918-447-0046

Provider Business Practice Location Address
First Line	:	4940 S UNION AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74107-7840
Country	:	US
Telephone Number	:	918-447-6867
Fax Number	:	918-447-0046

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	03/24/2020

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