Provider Demographics
NPI:1902596372
Name:ROBERT A WHIPPLE, LTD.
Entity Type:Organization
Organization Name:ROBERT A WHIPPLE, LTD.
Other - Org Name:EMERALD BAY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WHIPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-218-2284
Mailing Address - Street 1:1824 WINCANTON DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6171
Mailing Address - Country:US
Mailing Address - Phone:702-562-1230
Mailing Address - Fax:702-447-8998
Practice Address - Street 1:7473 W LAKE MEAD BLVD STE 213
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0265
Practice Address - Country:US
Practice Address - Phone:702-562-1230
Practice Address - Fax:702-410-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty