Individual
DR. SHAMANT TIPPOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1235 E CHEROKEE ST, ST JOHN'S CLINIC HOSPITALIST DEPARTMENT, SPRINGFIELD, MO 65804-2203
(417) 820-2600
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125050620
IL
207R00000X
Internal Medicine Physician
2011006614
MO
208M00000X
Hospitalist Physician
Primary
2011006614
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679744809
—
MO
Enumeration date
03/15/2008
Last updated
05/09/2017
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