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Individual

DR. GARY TIPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7347 BELL CREEK RD, SUITE 100, MECHANICSVILLE, VA 23111-3504
(804) 559-9430
(804) 559-2037
Mailing address
9900 INDEPENDENCE PARK DR, SUITE 100, RICHMOND, VA 23233-1473
(804) 747-1855
(804) 762-8837

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101-031425
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
179100
ANTHEM
01
329785
SOUTHERN HEALTH
05
6703739
VA
05
6730043
VA
01
7925863
CIGNA
Enumeration date
08/21/2006
Last updated
07/09/2007
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