Provider Demographics
NPI:1194906909
Name:DANIEL R. WHIPPLE MD PC
Entity type:Organization
Organization Name:DANIEL R. WHIPPLE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-272-2020
Mailing Address - Street 1:8244 E US HIGHWAY 36 STE 200
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9621
Mailing Address - Country:US
Mailing Address - Phone:317-272-2020
Mailing Address - Fax:317-272-6544
Practice Address - Street 1:8244 E US HIGHWAY 36 STE 200
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9621
Practice Address - Country:US
Practice Address - Phone:317-272-2020
Practice Address - Fax:317-272-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039952207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INDG6130OtherMEDICARE RETIRED RAILROAD
IN000000088982OtherBCBS
IN100134080AMedicaid
IN100134080AMedicaid
INDG6130OtherMEDICARE RETIRED RAILROAD
IN344500Medicare PIN