| Doctor Name: | JOHN NATHAN TRIPP |
| NPI Number: | 1568663193 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 15519 |
| Business Practice Address: | Old Bethel Church Rd Chester, GA - 31012 |
| Business Phone Number: | 4783587315 |
| Business Fax Number: | 4783587309 |
| Mailing Address: | 4801 Wesleyan Woods Dr, MACON |
| State: | GA |
| Postal Code: | 312104116 |
| Phone Number: | 4784749550 |
| Fax Number: | 4784749550 |
| NPI Enumeration Date: | 05/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15519 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |