Provider Demographics
NPI:1124298641
Name:RIPPY, JAMES VALE JR (AUD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:VALE
Last Name:RIPPY
Suffix:JR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 W MARKHAM ST STE 207
Mailing Address - Street 2:AFFILIATED AUDIOLOGY CENTER, INC.
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-1579
Mailing Address - Country:US
Mailing Address - Phone:501-224-6910
Mailing Address - Fax:866-483-2873
Practice Address - Street 1:10310 W MARKHAM ST STE 207
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1579
Practice Address - Country:US
Practice Address - Phone:501-224-6910
Practice Address - Fax:866-483-2873
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR44231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1124298641Medicaid
AR1659494136OtherCLINIC NPI NUMBER
AR56383Medicare PIN