Provider Demographics
NPI:1447335708
Name:WHIPPLE, PAUL F (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:WHIPPLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:F
Other - Last Name:WHIPPLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO PA
Mailing Address - Street 1:PO BOX 509
Mailing Address - Street 2:
Mailing Address - City:DERMOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71638-0509
Mailing Address - Country:US
Mailing Address - Phone:870-538-5414
Mailing Address - Fax:870-538-5412
Practice Address - Street 1:110 N DREW ST
Practice Address - Street 2:
Practice Address - City:STAR CITY
Practice Address - State:AR
Practice Address - Zip Code:71667-5704
Practice Address - Country:US
Practice Address - Phone:870-628-5391
Practice Address - Fax:870-628-5393
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR124036003Medicaid
F24077Medicare UPIN