Provider Demographics
NPI:1699781450
Name:LIPSMEYER, ELEANOR ANN (MD)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ANN
Last Name:LIPSMEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST
Mailing Address - Street 2:SLOT 509
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-5586
Mailing Address - Fax:501-603-1380
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:SLOT 509
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-5586
Practice Address - Fax:501-603-1380
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC 3112207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B90388Medicare UPIN
53168Medicare ID - Type Unspecified