Provider Demographics
NPI:1598701922
Name:LIPMAN, RANDEE E (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDEE
Middle Name:E
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3219
Mailing Address - Country:US
Mailing Address - Phone:316-616-3333
Mailing Address - Fax:316-616-0974
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1197
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:620-694-4225
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23573207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100125840GMedicaid
KS100125840GMedicaid
KSKA2454001OtherBLUE CROSS BLUE SHIELD OF KANSAS
KSKA2454001Medicare PIN