Provider Demographics
NPI:1548207384
Name:KUIPER, HENDRIK K (MD)
Entity Type:Individual
Prefix:DR
First Name:HENDRIK
Middle Name:K
Last Name:KUIPER
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 1:41 SGT. S. PRENTISS DRIVE
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120
Mailing Address - Country:US
Mailing Address - Phone:601-442-5388
Mailing Address - Fax:601-445-5850
Practice Address - Street 1:41 SGT. S. PRENTISS DRIVE
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-442-5388
Practice Address - Fax:601-445-5850
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08005208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00016640Medicaid
B30634Medicare UPIN
MS020000461Medicare ID - Type Unspecified
MS00016640Medicaid