Provider Demographics
NPI:1295727246
Name:KIPLIN, LYDELL CRAIG (MD)
Entity type:Individual
Prefix:DR
First Name:LYDELL
Middle Name:CRAIG
Last Name:KIPLIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12735 CRANES ML
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1957
Mailing Address - Country:US
Mailing Address - Phone:210-492-6669
Mailing Address - Fax:210-492-6669
Practice Address - Street 1:12735 CRANES ML
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1957
Practice Address - Country:US
Practice Address - Phone:210-492-6669
Practice Address - Fax:210-492-6669
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD2797207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology