Provider Demographics
NPI:1972565414
Name:SHIPMAN, JULIA KATHERINE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:KATHERINE
Last Name:SHIPMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:KATHERINE
Other - Last Name:BISEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3501 SE WILLOUGHBY BLVD.
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997
Mailing Address - Country:US
Mailing Address - Phone:772-288-0304
Mailing Address - Fax:772-288-1371
Practice Address - Street 1:3501 SE WILLOUGHBY BLVD.
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997
Practice Address - Country:US
Practice Address - Phone:772-288-0304
Practice Address - Fax:772-288-1371
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8759207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270476500Medicaid
48010ZMedicare UPIN
FLI07983Medicare UPIN