Provider Demographics
NPI:1841212917
Name:LIPTON, JAMES A (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:LIPTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 WEDGE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4540
Mailing Address - Country:US
Mailing Address - Phone:757-228-5565
Mailing Address - Fax:757-228-5565
Practice Address - Street 1:516 WEDGE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4540
Practice Address - Country:US
Practice Address - Phone:757-228-5565
Practice Address - Fax:757-228-5565
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102050101204D00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010142351Medicaid
VA007383O04Medicare ID - Type Unspecified
VAI32200Medicare UPIN