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General NPI Number Information
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NPI Number | 1962486027
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Entity Type | Individual
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Provider Name | MATTHEW CARL JEPSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 10503 W THUNDERBIRD BLVD STE 104
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City | SUN CITY
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State | AZ
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Zip | 85351-3047
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Country | US
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Telephone | 623-975-1660
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Fax | 623-584-4282
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Provider Business Mailing Address
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Address Line | 14510 W SHUMWAY DR STE 101
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5815
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Country | US
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Telephone | 623-975-1660
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Fax | 623-584-4282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 76971
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME149465
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 78872-8905
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 46765
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License Number State | MN
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