Provider Demographics
NPI:1215495296
Name:KLIPPENSTEIN, STEPHEN (DO)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:KLIPPENSTEIN
Suffix:
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 1:47 FINCH CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7572
Mailing Address - Country:US
Mailing Address - Phone:775-750-0906
Mailing Address - Fax:
Practice Address - Street 1:47 FINCH CT
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7572
Practice Address - Country:US
Practice Address - Phone:775-750-0906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT032.0134181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine