Organization
TIPPIN FAMILY MEDICINE CLINIC, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE JEAN BANNING-TIPPIN M.D. (OFFICE MANAGER/PHYSCIAN)
(479) 495-7300
Entity
Organization
Contact information
Practice address
804 DANARK CIRCLE, DANVILLE, AR 72833-0220
(479) 495-7300
(479) 495-7981
Mailing address
804 DANARK CIRCLE, P O BOX 220, DANVILLE, AR 72833-0220
(479) 495-7300
(479) 495-7981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121819002
—
AR
Enumeration date
08/14/2006
Last updated
05/15/2013
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