Individual
DR. DOUGLAS B TIPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PHD
Contact information
Practice address
4405 WEAVER PKWY, WARRENVILLE, IL 60555-3269
(630) 933-7811
(630) 352-5349
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
40881
CO
2085R0001X
Radiation Oncology Physician
Primary
036164254
IL
2085R0001X
Radiation Oncology Physician
C154753
CA
2085R0001X
Radiation Oncology Physician
CDRH.0040881
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04004909
—
CO
Enumeration date
08/23/2005
Last updated
09/29/2025
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