Provider Demographics
NPI:1417477910
Name:BOPP, AUSTIN JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JOSEPH
Last Name:BOPP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:213 S JEFFERSON ST
Mailing Address - Street 2:STE 625
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011
Mailing Address - Country:US
Mailing Address - Phone:540-224-5372
Mailing Address - Fax:540-224-5684
Practice Address - Street 1:2900 LAMB CIR; 2900 TYLER RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-731-2000
Practice Address - Fax:540-731-5264
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL407132084P0800X
VA01022060132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry