Provider Demographics
NPI:1164413431
Name:WHIPPLE, DANIEL ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:WHIPPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2601 STOUT HERITAGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-5557
Mailing Address - Country:US
Mailing Address - Phone:317-272-2020
Mailing Address - Fax:317-272-6544
Practice Address - Street 1:2601 STOUT HERITAGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-5557
Practice Address - Country:US
Practice Address - Phone:317-272-2020
Practice Address - Fax:317-272-6544
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039952207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100134080AMedicaid
180014267OtherMEDICARE RETIRED RAILROAD
IN000000088982OtherBCBS
IN1067250001Medicare NSC