Individual
JAMES DAVIS TIPTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4420 DIXIE HWY STE 126, LOUISVILLE, KY 40216-2994
(502) 810-3780
(502) 394-3607
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44052
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000765950
ANTHEM - NICC
KY
01
—
135332
SIHO - NICC
KY
01
—
K043420
MEDICARE - NICC
KY
Enumeration date
03/29/2008
Last updated
03/05/2021
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