MEDICARE: DR. JUDITH HOLT HIPPLE D.O.

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	208000000X	Pediatrics Physician	OS007595L	PA

General Provider Information

NPI Number	:	1427037027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH HOLT HIPPLE D.O.

Provider Business Mailing Address
First Line	:	524 WHEATFIELD DR
Second Line	:
City	:	LITITZ
State	:	PA
Zip	:	17543-9074
Country	:	US
Telephone Number	:	717-569-1251
Fax Number	:	717-569-3903

Provider Business Practice Location Address
First Line	:	1725 OREGON PIKE
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17601-4206
Country	:	US
Telephone Number	:	717-569-8518
Fax Number	:	717-569-3903

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	07/08/2007

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