Provider Demographics
NPI:1518923317
Name:LOPOO, JOHN B JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:LOPOO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 CONSTANTIN BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3481
Mailing Address - Country:US
Mailing Address - Phone:225-769-2295
Mailing Address - Fax:225-769-2297
Practice Address - Street 1:8200 CONSTANTIN BLVD STE 220
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3481
Practice Address - Country:US
Practice Address - Phone:225-769-2295
Practice Address - Fax:225-769-2297
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15492R2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1460621Medicaid
LA1460621Medicaid