Provider Demographics
NPI:1407831712
Name:TRIPLETT, GEORGE E (PHD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:TRIPLETT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 MORGANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-2824
Mailing Address - Country:US
Mailing Address - Phone:863-370-3331
Mailing Address - Fax:863-683-4654
Practice Address - Street 1:1443 MORGANWOOD DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-2824
Practice Address - Country:US
Practice Address - Phone:863-370-3331
Practice Address - Fax:863-683-4654
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6110103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist