Provider Demographics
NPI:1043365190
Name:DOEPPER, JOHN RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RICHARD
Last Name:DOEPPER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 COSTELLO DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-6801
Mailing Address - Country:US
Mailing Address - Phone:540-665-4444
Mailing Address - Fax:540-665-4473
Practice Address - Street 1:230 COSTELLO DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4300
Practice Address - Country:US
Practice Address - Phone:540-665-4444
Practice Address - Fax:540-665-4473
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001664111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA249691OtherANTHEM