Provider Demographics
NPI:1629098173
Name:KYLE M. TIPTON, M.D., P.A.
Entity Type:Organization
Organization Name:KYLE M. TIPTON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-321-2100
Mailing Address - Street 1:700 W CENTRAL AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-2184
Mailing Address - Country:US
Mailing Address - Phone:316-321-2100
Mailing Address - Fax:316-321-0270
Practice Address - Street 1:700 W CENTRAL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:EL DORADO
Practice Address - State:KS
Practice Address - Zip Code:67042-2184
Practice Address - Country:US
Practice Address - Phone:316-321-2100
Practice Address - Fax:316-321-0270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty