Basic Information
| Provider Information | |||||||||
| NPI: | 1972583599 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIPPEN | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1553 CHESTER PIKE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRUM LYNNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190221022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104997180 | ||||||||
| FaxNumber: | 6108760859 | ||||||||
| Practice Location | |||||||||
| Address1: | 1553 CHESTER PIKE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRUM LYNNE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190221022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104997180 | ||||||||
| FaxNumber: | 6108760859 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 11/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35940 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A103982 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD456532 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.