Provider Demographics
NPI:1629130042
Name:PIPKIN, MICHAEL EDWARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:EDWARD
Last Name:PIPKIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3037 LITTLE BEAR HWY
Mailing Address - Street 2:
Mailing Address - City:GILBERTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42044-9207
Mailing Address - Country:US
Mailing Address - Phone:270-362-7933
Mailing Address - Fax:
Practice Address - Street 1:3037 LITTLE BEAR HWY
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42044-9207
Practice Address - Country:US
Practice Address - Phone:270-362-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10139183500000X
TN4539183500000X
IN26020960A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist