Provider Demographics
NPI:1366475709
Name:SAUL LIPSMAN DPM MDPA
Entity Type:Organization
Organization Name:SAUL LIPSMAN DPM MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-967-7600
Mailing Address - Street 1:6894 LAKE WORTH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467
Mailing Address - Country:US
Mailing Address - Phone:561-967-7600
Mailing Address - Fax:561-967-7177
Practice Address - Street 1:6894 LAKE WORTH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-967-7600
Practice Address - Fax:561-967-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94829OtherBLUE SHIELD
FL94829OtherBLUE SHIELD