Provider Demographics
NPI:1639193675
Name:PIPO, JAMES EDWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EDWARD
Last Name:PIPO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 HILLIARD ROME OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7287
Mailing Address - Country:US
Mailing Address - Phone:614-777-1111
Mailing Address - Fax:614-777-7920
Practice Address - Street 1:5555 HILLIARD ROME OFFICE PARK
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7287
Practice Address - Country:US
Practice Address - Phone:614-777-1111
Practice Address - Fax:614-777-7920
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4381T287152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPI0882844Medicare PIN
OHU76022Medicare UPIN
OHPI0882845Medicare PIN
OHPI0882843Medicare PIN