# JASON DIPMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1053694976
- **Gender:** Man
- **Credential:** AA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 2011032475 | MO | — |
| 367H00000X | Anesthesiologist Assistant | 1227 | MI | Yes |

## Other

- **Enumeration date:** 09/27/2011
- **Last updated:** 12/13/2018