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NPI Code Detail

MEDICARE: JEFFREY TODD LIPSCOMB PA

MEDICARE: JEFFREY TODD LIPSCOMB PA
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
1363A00000XPhysician AssistantPA2374FL

Other Identifiers

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

General Provider Information

NPI Number : 1558350124
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY TODD LIPSCOMB PA
Provider Business Mailing Address
First Line : 455 PINELLAS ST
Second Line : STE 400
City : CLEARWATER
State : FL
Zip : 33756-3356
Country : US
Telephone Number : 727-445-1992
Fax Number : 727-445-1993
Provider Business Practice Location Address
First Line : 455 PINELIAS ST
Second Line : STE 400
City : CLEARWATER
State : FL
Zip : 33756-3356
Country : US
Telephone Number : 727-445-1911
Fax Number : 727-445-1986
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 10/26/2012

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Directions to “ JEFFREY TODD LIPSCOMB PA” Practice Location

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