Provider Demographics
NPI:1619146719
Name:DANIEL R WHIPPLE MD PC
Entity Type:Organization
Organization Name:DANIEL R WHIPPLE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-272-2020
Mailing Address - Street 1:8244 E US HIGHWAY 36 STE 200
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9621
Mailing Address - Country:US
Mailing Address - Phone:317-272-2020
Mailing Address - Fax:317-272-6544
Practice Address - Street 1:8244 E US HIGHWAY 36 STE 200
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9621
Practice Address - Country:US
Practice Address - Phone:317-272-2020
Practice Address - Fax:317-272-6544
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL R WHIPPLE MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-22
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039952332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DG6130OtherMEDICARE RETIRED RAILROAD
1067250001Medicare NSC