Provider Demographics
NPI:1073553996
Name:JOPLIN, ANDREA CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CHRISTINE
Last Name:JOPLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:628 ROOSEVELT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-4867
Mailing Address - Country:US
Mailing Address - Phone:320-774-3789
Mailing Address - Fax:320-774-3483
Practice Address - Street 1:628 ROOSEVELT RD STE 101
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-4867
Practice Address - Country:US
Practice Address - Phone:320-774-3789
Practice Address - Fax:320-774-3483
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN36576207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F60788Medicare UPIN