Provider Demographics
NPI:1902811300
Name:NIPPER, ELLIOTT BRANSCOME (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:BRANSCOME
Last Name:NIPPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1501 LOUISVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6025
Mailing Address - Country:US
Mailing Address - Phone:318-323-8451
Mailing Address - Fax:318-361-2613
Practice Address - Street 1:1501 LOUISVILLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-323-8451
Practice Address - Fax:318-361-2613
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20054207XX0801X
LA305504207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma