Provider Demographics
NPI:1902119894
Name:SIPARSKY, PATRICK NEAL (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:NEAL
Last Name:SIPARSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:567-661-0328
Mailing Address - Fax:419-479-2639
Practice Address - Street 1:1801 N SENATE BLVD STE 535
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1204
Practice Address - Country:US
Practice Address - Phone:317-944-9400
Practice Address - Fax:317-963-1955
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.121809207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0088465Medicaid