Individual
DALLAS W LIPSCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
600 NM HWY 195, STE A, ELEPHANT BUTTE, NM 87935-0449
(575) 744-4872
(575) 548-7290
Mailing address
PO BOX 449, ELEPHANT BUTTE, NM 87935-0449
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2013-0027
NM
363A00000X
Physician Assistant
—
IL
Other
Enumeration date
07/15/2005
Last updated
09/23/2020
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