MEDICARE: DR. KENNETH IRWIN LIPOW 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	207T00000X	Neurological Surgery Physician	MD61575451	WA
2	207T00000X	Neurological Surgery Physician	026386	CT

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
2	C01733	OTHER		MEDICAL GROUP #

General Provider Information

NPI Number	:	1427083674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH IRWIN LIPOW M.D.

Provider Business Mailing Address
First Line	:	888 SWIFT BLVD
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-3514
Country	:	US
Telephone Number	:	509-946-4611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 GOETHALS DR STE B
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-3301
Country	:	US
Telephone Number	:	509-942-3067
Fax Number	:	509-942-3085

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	02/06/2025

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Directions to “ DR. KENNETH IRWIN LIPOW M.D.” Practice Location

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