Provider Demographics
NPI:1336407261
Name:LIPPARD, LAUREN ORLANDO (DO)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ORLANDO
Last Name:LIPPARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 MALCOLM BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:CONNELLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:28612-8079
Mailing Address - Country:US
Mailing Address - Phone:828-874-4600
Mailing Address - Fax:828-874-8900
Practice Address - Street 1:730 MALCOLM BLVD STE 150
Practice Address - Street 2:
Practice Address - City:CONNELLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28612-8079
Practice Address - Country:US
Practice Address - Phone:828-874-4600
Practice Address - Fax:828-874-8900
Is Sole Proprietor?:No
Enumeration Date:2012-04-28
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-00113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1336407261Medicaid