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Individual
JOHN DOUGLAS IPSEN
Active
Individual
JOHN DOUGLAS IPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32307-20
WI
207Q00000X
Family Medicine Physician
37146
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080005095
MEDICARE PIN
MN
05
—
220313800
—
MN
Enumeration date
05/13/2006
Last updated
07/14/2017
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