Provider Demographics
NPI:1518967017
Name:BOPP, FELIX PLANCHE (MD)
Entity Type:Individual
Prefix:DR
First Name:FELIX
Middle Name:PLANCHE
Last Name:BOPP
Suffix:
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 1:3421 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3733
Mailing Address - Country:US
Mailing Address - Phone:504-455-9933
Mailing Address - Fax:504-888-8221
Practice Address - Street 1:3421 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3733
Practice Address - Country:US
Practice Address - Phone:504-455-9933
Practice Address - Fax:504-888-8221
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL#06701R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1366820Medicaid
LA795641OtherBCBS HIGHMARK #
LA1197921OtherCIGNA INDIVIDUAL #
LAB62717Medicare UPIN
LA1197921OtherCIGNA INDIVIDUAL #