Provider Demographics
NPI:1841377413
Name:LIPPERT, DONALD M (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:M
Last Name:LIPPERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:133 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-8924
Mailing Address - Country:US
Mailing Address - Phone:417-294-5203
Mailing Address - Fax:417-829-4316
Practice Address - Street 1:5571 GRETNA RD
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-7287
Practice Address - Country:US
Practice Address - Phone:417-336-4355
Practice Address - Fax:417-337-5141
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2002002068207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205758204Medicaid
MO404013268Medicare PIN
MO128013230Medicare PIN
MO205758204Medicaid