Organization
KEN LIPPINCOTT, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES KENNETH LIPPINCOTT (OWNER)
(662) 844-3739
Entity
Organization
Contact information
Practice address
4428 SOUTH EASON BOULEVARD, SUITE A, TUPELO, MS 38801-6506
(662) 844-3739
(662) 844-3728
Mailing address
4428 SOUTH EASON BOULEVARD, SUITE A, TUPELO, MS 38801-6506
(662) 844-3739
(662) 844-3728
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
09148
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016260
—
MS
01
—
DG6420
RAILROAD MEDICARE
MS
Enumeration date
07/02/2006
Last updated
01/03/2013
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