Provider Demographics
NPI:1629194188
Name:IPPEN, GREGORY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:IPPEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 FRANKLIN ST
Mailing Address - Street 2:CPMG HOSPITALIST SERVICES, 5TH FLOOR
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1126
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:1835 FRANKLIN ST
Practice Address - Street 2:CPMG HOSPITALIST SERVICES, 5TH FLOOR
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1126
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23978207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01239789Medicaid
014231OtherKAISER-COMMERCIAL NUMBER
COD24369Medicare UPIN
COC481088Medicare PIN