Provider Demographics
NPI:1801930896
Name:CIPPEL, JOSEPH A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:CIPPEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-0579
Mailing Address - Country:US
Mailing Address - Phone:724-543-8164
Mailing Address - Fax:724-543-8616
Practice Address - Street 1:116 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELDERTON
Practice Address - State:PA
Practice Address - Zip Code:15736
Practice Address - Country:US
Practice Address - Phone:724-354-5258
Practice Address - Fax:724-354-4396
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057764L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA898783OtherBLUE SHIELD
PA1007459070026Medicaid
PA1012923OtherGATEWAY
PA70707OtherUNISON
PA1012923OtherGATEWAY
PA1007459070026Medicaid