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Individual

MR. RICHARD C SIPE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3231 GLYNN AVE, BRUNSWICK, GA 31520-4851
(912) 265-9006
(912) 554-3636
Mailing address
3231 GLYNN AVE, BRUNSWICK, GA 31520-4851
(912) 265-9006
(912) 554-3636

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
357432493A
GA
01
GRP3915
MEDICARE GROUP NUMBER
GA
Enumeration date
03/24/2009
Last updated
07/17/2009
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