Provider Demographics
NPI:1457092629
Name:IPSEN, STEVEN K JR (DO)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:K
Last Name:IPSEN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10092 S MAJESTIC CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-4524
Mailing Address - Country:US
Mailing Address - Phone:801-541-5172
Mailing Address - Fax:
Practice Address - Street 1:OSU MEDICAL CENTER 744 WEST 9TH STREET TULSA, OK 74127-
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127
Practice Address - Country:US
Practice Address - Phone:918-599-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program