Individual
MR. BENJAMIN V TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPA-C
Contact information
Practice address
108 CENTRE ST, MIDCOAST MEDICAL GROUP, BATH, ME 04530-2550
(207) 386-1800
(207) 386-1801
Mailing address
108 CENTRE ST, MIDCOAST MEDICAL GROUP, BATH, ME 04530-2550
(207) 386-1800
(207) 386-1801
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA001117
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432800299
—
ME
Enumeration date
09/21/2005
Last updated
07/22/2015
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