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NPI Code Detail

MEDICARE: KIM R LIPSCOMB M.D.

MEDICARE:   KIM R LIPSCOMB  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
1207VM0101XMaternal & Fetal Medicine Physician58696GA

General Provider Information

NPI Number : 1780739359
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM R LIPSCOMB M.D.
Provider Business Mailing Address
First Line : 980 JOHNSON FERRY RD NE STE 620
Second Line :
City : ATLANTA
State : GA
Zip : 30342-1608
Country : US
Telephone Number : 404-255-2057
Fax Number : 404-303-2015
Provider Business Practice Location Address
First Line : 980 JOHNSON FERRY RD NE STE 620
Second Line :
City : ATLANTA
State : GA
Zip : 30342-1608
Country : US
Telephone Number : 404-255-2057
Fax Number : 404-303-2015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 07/08/2007

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Directions to “ KIM R LIPSCOMB M.D.” Practice Location

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