Provider Demographics
NPI:1366452047
Name:WHIPPLE, RICHARD R (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:WHIPPLE
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 1:1367 WASHINGTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1043
Mailing Address - Country:US
Mailing Address - Phone:518-489-2666
Mailing Address - Fax:518-489-5933
Practice Address - Street 1:1367 WASHINGTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1043
Practice Address - Country:US
Practice Address - Phone:518-489-2666
Practice Address - Fax:518-489-5933
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1621408207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01030675Medicaid
NY80G201OtherEMPIRE BC
NY18414OtherMVP
NY000420050005OtherBS NENY
NY10002174OtherCDPHP
NY5838310OtherAETNA
NY01030675Medicaid
NY000420050005OtherBS NENY