Individual
RICHARD THOMAS SIPES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8625 LINE AVE STE E, SHREVEPORT, LA 71106-6107
(318) 935-6177
(888) 935-4748
Mailing address
8625 LINE AVE STE E, SHREVEPORT, LA 71106-6107
(318) 935-6177
(888) 935-4748
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
13289R
LA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
13289R
LA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
13289R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578827
—
LA
01
—
385661030D
BCBS
LA
Enumeration date
06/17/2005
Last updated
09/11/2023
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