Provider Demographics
NPI:1538263926
Name:KLIPPLE, GARY L (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:L
Last Name:KLIPPLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 440438
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0438
Mailing Address - Country:US
Mailing Address - Phone:865-670-6199
Mailing Address - Fax:865-670-6188
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:STE 550
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-546-6554
Practice Address - Fax:865-522-4634
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD00007134207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3087989Medicaid
TNF96701Medicare UPIN
TN3087989Medicare PIN
TNP00208491Medicare PIN