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MR. JASON MICHAEL TIPPIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3130 N COUNTY RD 25A, SUITE 109, TROY, OH 45373-1337
(937) 440-9292
(937) 440-4227
Mailing address
3130 N COUNTY RD 25A, SUITE 109, TROY, OH 45373-1337
(937) 440-9292
(937) 440-4227

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001557
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0124214
OH
Enumeration date
08/09/2005
Last updated
09/15/2015
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