Provider Demographics
NPI:1477894848
Name:HOEPPNER, DUANE R (BOCO,BOCPED)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:R
Last Name:HOEPPNER
Suffix:
Gender:M
Credentials:BOCO,BOCPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2405
Mailing Address - Country:US
Mailing Address - Phone:517-783-1313
Mailing Address - Fax:
Practice Address - Street 1:1005 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2405
Practice Address - Country:US
Practice Address - Phone:517-783-1313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist