Provider Demographics
NPI:1851555411
Name:TRIPP, DUSTIN RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:RYAN
Last Name:TRIPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-335-2299
Mailing Address - Fax:417-269-2080
Practice Address - Street 1:890 HWY 248
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-3721
Practice Address - Country:US
Practice Address - Phone:417-335-2299
Practice Address - Fax:417-269-2080
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2008016564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine