Provider Demographics
NPI:1356828818
Name:FLIPPIN, RICKEY JR
Entity Type:Individual
Prefix:MR
First Name:RICKEY
Middle Name:
Last Name:FLIPPIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MANSON AVE APT 419
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6657
Mailing Address - Country:US
Mailing Address - Phone:504-957-0500
Mailing Address - Fax:
Practice Address - Street 1:4949 BULLARD AVE STE E
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-3141
Practice Address - Country:US
Practice Address - Phone:504-342-2704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator