Provider Demographics
NPI:1235185489
Name:TIPTON & UNROE, PSC
Entity Type:Organization
Organization Name:TIPTON & UNROE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:UNROE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-447-4500
Mailing Address - Street 1:6801 DIXIE HWY
Mailing Address - Street 2:SUITE 134
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3913
Mailing Address - Country:US
Mailing Address - Phone:502-447-4500
Mailing Address - Fax:502-449-0108
Practice Address - Street 1:6801 DIXIE HWY
Practice Address - Street 2:SUITE 134
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3913
Practice Address - Country:US
Practice Address - Phone:502-447-4500
Practice Address - Fax:502-449-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00205213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80903537Medicaid
KY=========OtherUNITED HEALTH CARE ID #
KY80903537Medicaid
KY=========OtherCIGNA ID #
KY=========OtherCIGNA ID #
KY80903537Medicaid