Provider Demographics
NPI:1760476634
Name:LIPPA, ANN M (OD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:LIPPA
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2020 WADSWORTH BLVD
Mailing Address - Street 2:SUITE 11A
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-5728
Mailing Address - Country:US
Mailing Address - Phone:303-431-1221
Mailing Address - Fax:303-867-4524
Practice Address - Street 1:2020 WADSWORTH BLVD
Practice Address - Street 2:SUITE 11A
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-5728
Practice Address - Country:US
Practice Address - Phone:303-431-1221
Practice Address - Fax:303-867-4524
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2008-05-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO2501152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU96147Medicare UPIN