Provider Demographics
NPI:1477550895
Name:LIPSKY, STEPHEN N (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:N
Last Name:LIPSKY
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 1:5185 PEACHTREE PKWY STE 350
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-6545
Mailing Address - Country:US
Mailing Address - Phone:770-858-5437
Mailing Address - Fax:770-796-0298
Practice Address - Street 1:5185 PEACHTREE PKWY STE 350
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-6545
Practice Address - Country:US
Practice Address - Phone:770-858-5437
Practice Address - Fax:770-796-0298
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048263207W00000X
GA42863207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2426629OtherAETNA HMO
GA797524OtherBCBS
GA977525OtherBCBS
GA003228451AMedicaid
GA34619OtherCOVENTRY PPO
GA7596169OtherAETNA
GA977200OtherBCBS
GA0800220OtherUHC
GA74202OtherCOVENTRY HMO
GA180038347OtherRR MEDICARE
GA582209517OtherWORK COMP
GA2426629OtherAETNA HMO
GA797524OtherBCBS
GA582209517OtherWORK COMP
GAG27681Medicare UPIN
GA00850935FMedicaid
GA18BDGQNMedicare PIN
GA977200OtherBCBS
GA00850935DMedicaid