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Individual

DR. WAYNE E TIPPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
6015 SHALLOWFORD ROAD, CHATTANOOGA, TN 37421-1688
(423) 893-3333
(423) 954-3054
Mailing address
6015 SHALLOWFORD ROAD, CHATTANOOGA, TN 37421-1688
(423) 893-3333
(423) 954-3054

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2083
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2004791
BCBSTN PROVIDER NUMBER
TN
05
3215429
TN
01
4665595
AETNA PROVIDER NUMBER
TN
Enumeration date
05/25/2005
Last updated
07/01/2016
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