MEDICARE: DR. EVAN TIPIKIN D.C.

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	111N00000X	Chiropractor	394	AK

General Provider Information

NPI Number	:	1639292477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVAN TIPIKIN D.C.

Provider Business Mailing Address
First Line	:	2008 E NORTHERN LIGHTS BLVD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4101
Country	:	US
Telephone Number	:	907-677-9215
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 E NORTHERN LIGHTS BLVD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4101
Country	:	US
Telephone Number	:	907-677-9215
Fax Number	:

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	09/28/2009

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