Provider Demographics
NPI:1720224116
Name:WHIPP, STEPHEN VINH (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:VINH
Last Name:WHIPP
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 1:2020 SILVER CREEK RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-8476
Mailing Address - Country:US
Mailing Address - Phone:928-704-4327
Mailing Address - Fax:
Practice Address - Street 1:2020 SILVER CREEK RD STE 206
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-8476
Practice Address - Country:US
Practice Address - Phone:928-704-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ41812207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZFQ31815OtherMEDICARE
Z155421OtherMEDICARE
031881OtherMEDICARE
AZ428520Medicaid