Individual
JEFFREY RIPPERDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7 SOUTH HOSPITAL DRIVE, MURPHYSBORO, IL 62966-3333
(618) 687-3418
(618) 687-1859
Mailing address
109 CALIFORNIA, P O BOX 577, CARTERVEILL, IL 62918-0577
(618) 985-8221
(618) 985-4635
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116271
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116271
—
IL
05
—
370966854002
—
IL
01
—
CF3444
MEDICARE RAILROAD GROUP
IL
01
—
P00625296
MEDICARE RR GROUP PTAN
IL
Enumeration date
07/26/2006
Last updated
12/11/2020
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