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NPI Code Detail

MEDICARE: DR. ISAAC JAMES LIPPE M.D.

MEDICARE: DR. ISAAC JAMES LIPPE 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
1207Q00000XFamily Medicine PhysicianL3733TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00035473OTHERTXRR/MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21588394-02OTHERTXCSHCN
38J8271OTHERTXBLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366403545
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISAAC JAMES LIPPE M.D.
Provider Business Mailing Address
First Line : PO BOX 18962
Second Line :
City : BELFAST
State : ME
Zip : 04915-4084
Country : US
Telephone Number : 800-566-5050
Fax Number : 254-537-6869
Provider Business Practice Location Address
First Line : 2100 LAKE SHORE DR
Second Line : #200
City : WACO
State : TX
Zip : 76708-1271
Country : US
Telephone Number : 254-537-6000
Fax Number : 254-537-6001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 01/06/2017

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