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NPI Code Detail

MEDICARE: LINDA S HIPPENHAMMER MD

MEDICARE: LINDA S HIPPENHAMMER MD
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
12085R0202XDiagnostic Radiology Physician01057609AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255516670
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA S HIPPENHAMMER MD
Provider Business Mailing Address
First Line : 6119 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-3072
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Provider Business Practice Location Address
First Line : 6119 W JEFFERSON BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-3072
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2008
Last Update Date : 08/19/2008

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Directions to “ LINDA S HIPPENHAMMER MD” Practice Location

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