Individual
DR. DEREK FOSTER IPSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, TRIPLER AMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Mailing address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER ATTN: MCHK-QS, TRIPLER AMC, HI 96859-5001
(808) 433-2460
(808) 433-1558
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
2001004848
MO
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
O-1368
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477532299
—
MO
Enumeration date
01/11/2006
Last updated
06/29/2021
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