Individual
DR. RUSSELL GARY TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(865) 548-1251
Mailing address
3946 MISER STATION RD, LOUISVILLE, TN 37777-3504
(865) 548-1251
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
55637
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q028612
—
TN
Enumeration date
04/13/2012
Last updated
07/03/2017
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