Individual
JOHN DOUGLAS IPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
(715) 685-7857
Mailing address
53585 NOKOMIS RD, ASHLAND, WI 54806-4272
(715) 682-7133
(715) 685-7857
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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