Provider Demographics
NPI:1598780652
Name:FLIPPIN, TONY A (MD)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:A
Last Name:FLIPPIN
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 1:7001 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4073
Mailing Address - Country:US
Mailing Address - Phone:479-314-7490
Mailing Address - Fax:479-314-7494
Practice Address - Street 1:7001 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4073
Practice Address - Country:US
Practice Address - Phone:479-314-7490
Practice Address - Fax:479-314-7494
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-4986207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102550001Medicaid
AR51711OtherBLUE CROSS/BLUE SHIELD PROVIDER NUMBER
90000005OtherRR MEDICARE
B90194Medicare UPIN