Individual
DR. KIPP ALLEN VANCAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
604 LOVEJOY LN STE 100, WOODSTOCK, GA 30189-3634
(770) 268-4336
(470) 251-6063
Mailing address
3333 RIVERWOOD PKWY SE STE 250, ATLANTA, GA 30339-3304
(770) 914-0116
(770) 955-4278
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0525311
KS
2085R0202X
Diagnostic Radiology Physician
Primary
103575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002234960H
—
KS
05
—
100234960F
—
KS
01
—
104991
BCBS PROVIDER NUMBER
KS
01
—
106163
BCBS OF KS
KS
01
—
18484065
BCBS OF KANSAS CITY
MO
01
—
KA1066001
KS MEDICARE
KS
01
—
P00440177
RAILROAD MEDICARE GROUP DG5299
KS
01
—
P00477479
RR MEDICARE
KS
Enumeration date
06/04/2006
Last updated
03/26/2025
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