# DR. JENNIFER TANGTIPHAIBOONTANA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1497190177
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 65408 | MN | Yes |
| 207X00000X | Orthopaedic Surgery Physician | 72305 | WI | — |
| 207XX0801X | Orthopaedic Trauma Physician | MD60838780 | WA | — |

## Other

- **Enumeration date:** 05/07/2013
- **Last updated:** 08/14/2023