Individual
MARK GREGORY LIPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 W MEMORIAL RD, ER DEPT., OKLAHOMA CITY, OK 73120-8304
(405) 752-3733
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
16509
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101520A
—
OK
05
—
100101520B
—
OK
01
—
930046554
RR MEDICARE
OK
01
—
930126936
RR MEDICARE
OK
01
—
P00046981
RR MEDICARE
OK
Enumeration date
03/30/2006
Last updated
06/04/2012
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