Provider Demographics
NPI:1093011991
Name:TIPPETS, DUANE MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:MICHAEL
Last Name:TIPPETS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 LEIGHTON AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-5761
Mailing Address - Country:US
Mailing Address - Phone:256-236-4121
Mailing Address - Fax:256-237-5254
Practice Address - Street 1:731 LEIGHTON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5761
Practice Address - Country:US
Practice Address - Phone:256-236-4121
Practice Address - Fax:256-237-5254
Is Sole Proprietor?:No
Enumeration Date:2011-02-10
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO1260207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-27255OtherBLUE CROSS BLUE SHIELD OF ALABAMA
AL141206Medicaid
AL511-27255OtherBLUE CROSS BLUE SHIELD OF ALABAMA