Provider Demographics
NPI:1073612073
Name:LIPKE, DAVID WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAM
Last Name:LIPKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10558 W POLK RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47138-7013
Mailing Address - Country:US
Mailing Address - Phone:812-866-4282
Mailing Address - Fax:
Practice Address - Street 1:10558 W POLK RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:IN
Practice Address - Zip Code:47138-7013
Practice Address - Country:US
Practice Address - Phone:812-866-4282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01054965A207L00000X
KY35753207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology