Provider Demographics
NPI:1891883443
Name:SCHIPP, HEATH DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:HEATH
Middle Name:DANIEL
Last Name:SCHIPP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 LONE OAK RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-0370
Mailing Address - Country:US
Mailing Address - Phone:270-554-7661
Mailing Address - Fax:270-554-7683
Practice Address - Street 1:3240 LONE OAK RD
Practice Address - Street 2:SUITE C
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-0370
Practice Address - Country:US
Practice Address - Phone:270-554-7661
Practice Address - Fax:270-554-7683
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000322147OtherBLUE CROSS BLUE SHIELD
KY85002814Medicaid
U97035Medicare UPIN
KY000000322147OtherBLUE CROSS BLUE SHIELD