Provider Demographics
NPI:1437297678
Name:KROPP, JOSEPH P (PHD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:P
Last Name:KROPP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S ZETTEROWER AVE
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-4816
Mailing Address - Country:US
Mailing Address - Phone:912-489-8787
Mailing Address - Fax:912-489-6603
Practice Address - Street 1:108 S ZETTEROWER AVE
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-4816
Practice Address - Country:US
Practice Address - Phone:912-489-8787
Practice Address - Fax:912-489-6603
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001702103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10052972Medicaid
GA68BBCSQMedicare ID - Type UnspecifiedGA MEDICARE NUMBER