Individual
JON M TIPPIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
768 TAYLOR RD, KALAMA, WA 98625
(615) 345-5400
Mailing address
3 MARYLAND FARMS STE 200, BRENTWOOD, TN 37027-5005
(615) 345-5400
(888) 468-6603
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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