Individual
DR. JACK MORGAN LIPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6525 HOBSON ST. NE, ST PETERSBURG, FL 33702-6922
(727) 902-9400
Mailing address
6525 HOBSON ST. NE, ST PETERSBURG, FL 33702-6922
(727) 902-9400
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME038761
FL
207V00000X
Obstetrics & Gynecology Physician
ME38761
FL
208D00000X
General Practice Physician
ME38761
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280479400
—
FL
01
—
62330
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/01/2006
Last updated
05/08/2024
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