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NPI Code Detail

MEDICARE: DR. ALETHA WISSLER TIPPETT M.D.

MEDICARE: DR. ALETHA WISSLER TIPPETT 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 Physician39281KY
2207Q00000XFamily Medicine Physician35074933OH

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 : 1598769069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALETHA WISSLER TIPPETT M.D.
Provider Business Mailing Address
First Line : 10274 ALLIANCE RD
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4710
Country : US
Telephone Number : 513-891-3093
Fax Number : 513-891-9947
Provider Business Practice Location Address
First Line : 10274 ALLIANCE RD
Second Line :
City : BLUE ASH
State : OH
Zip : 45242-4710
Country : US
Telephone Number : 513-891-3093
Fax Number : 513-891-9947
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2005
Last Update Date : 10/19/2023

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