Provider Demographics
NPI:1376025973
Name:GOPALAM, GOPINATH (MS)
Entity Type:Individual
Prefix:MR
First Name:GOPINATH
Middle Name:
Last Name:GOPALAM
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40816
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70835-0816
Mailing Address - Country:US
Mailing Address - Phone:225-663-2881
Mailing Address - Fax:
Practice Address - Street 1:9938 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8193
Practice Address - Country:US
Practice Address - Phone:225-663-2881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical