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Individual

DR. JOHN M LIPKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
425 S VINE ST, BASTROP, LA 71220-4513
(318) 281-5422
(318) 281-4416
Mailing address
425 S VINE ST, BASTROP, LA 71220-4513
(318) 281-5422
(318) 281-4416

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1021611
LA
208600000X
Surgery Physician
Primary
1021611
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1494933
LA
Enumeration date
12/08/2005
Last updated
09/12/2016
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