Sipperley, Jack Owens

Sipperley, Jack Owens is an individual health care provider with primary practice located at 4800 N 22Nd St , Phoenix AZ 85016-4701. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Sipperley, Jack Owens can be contacted via phone (602) 955-1000.

Contact Information

Primary practice address
4800 N 22Nd St Phoenix AZ 85016-4701
Phone: (602) 955-1000
Fax: (602) 508-4830
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 16167 Arizona
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 16167 Arizona

Profile Details

NPI number 1235130402
LBN Legal business name Sipperley, Jack Owens
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated May 7th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235130402 NPPES
Arizona MEDICAID 285412

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