Provider Demographics
NPI:1548231673
Name:LIPPERT-KECK, JULIANNA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIANNA
Middle Name:PATRICIA
Last Name:LIPPERT-KECK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIANNA
Other - Middle Name:PATRICIA
Other - Last Name:LIPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:310 S SILVER SPRINGS RD
Mailing Address - Street 2:SOUTHEASTHEALTH WOUND & HYPERBARIC MEDICINE
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63703-6312
Mailing Address - Country:US
Mailing Address - Phone:573-334-9537
Mailing Address - Fax:573-335-0147
Practice Address - Street 1:310 S SILVER SPRINGS RD
Practice Address - Street 2:SOUTHEASTHEALTH WOUND & HYPERBARIC MEDICINE
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-6312
Practice Address - Country:US
Practice Address - Phone:573-334-9537
Practice Address - Fax:573-335-0147
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056184A208D00000X
MO2013038894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice