Provider Demographics
NPI:1821677352
Name:RIPPETOE, ADAM MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:MAX
Last Name:RIPPETOE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYLOR SCOTT & WHITE MEDICAL CENTER-TEMPLE
Mailing Address - Street 2:2401 SOUTH 31ST STREET, INSERT MAIL STOP HERE
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508
Mailing Address - Country:US
Mailing Address - Phone:254-724-5306
Mailing Address - Fax:
Practice Address - Street 1:BAYLOR SCOTT & WHITE MEDICAL CENTER-TEMPLE
Practice Address - Street 2:2401 SOUTH 31ST STREET, INSERT MAIL STOP HERE
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508
Practice Address - Country:US
Practice Address - Phone:254-724-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10074849390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program