Provider Demographics
NPI:1609133719
Name:HIPPENSTEEL, KIRK JAMES (MD)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:JAMES
Last Name:HIPPENSTEEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KJ
Other - Middle Name:
Other - Last Name:HIPPENSTEEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 80217
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85060-0217
Mailing Address - Country:US
Mailing Address - Phone:602-385-2115
Mailing Address - Fax:480-418-3323
Practice Address - Street 1:2902 W AGUA FRIA FWY STE 1090
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-3970
Practice Address - Country:US
Practice Address - Phone:623-848-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK147698171000000X, 207XX0005X
AZ71213207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No171000000XOther Service ProvidersMilitary Health Care Provider
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine