Individual
JON M TIPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
00022815
WA
2084N0400X
Neurology Physician
23642
IA
2084N0400X
Neurology Physician
MD2019-0927
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0196147
—
IA
01
—
37261
WELLMARK BCBS
IA
01
—
MD2019-0927
NEW MEXICO MEDICAL BOARD
NM
Enumeration date
11/17/2005
Last updated
02/21/2020
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