Provider Demographics
NPI:1063415131
Name:LUPLOW, ROLLAND E (MD)
Entity type:Individual
Prefix:DR
First Name:ROLLAND
Middle Name:E
Last Name:LUPLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:127 CRESTVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2855
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1357
Practice Address - Street 1:758 HIGHWAY 46 S
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2556
Practice Address - Country:US
Practice Address - Phone:615-446-2708
Practice Address - Fax:615-441-5121
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD15744207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3158217OtherBLUE CROSS BLUE SHIELD TN
080162954OtherRAILROAD MEDICARE PIN
TN3857407Medicaid
A97862Medicare UPIN
080162954OtherRAILROAD MEDICARE PIN