Provider Demographics
NPI:1558352732
Name:TOPARIS, ROBERT LEE (DO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:TOPARIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 SEVEN SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5098
Mailing Address - Country:US
Mailing Address - Phone:615-920-7782
Mailing Address - Fax:615-920-8775
Practice Address - Street 1:601 HOLDEN RD
Practice Address - Street 2:
Practice Address - City:HOLDEN
Practice Address - State:WV
Practice Address - Zip Code:25625
Practice Address - Country:US
Practice Address - Phone:304-239-2147
Practice Address - Fax:304-239-2309
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1098207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0052096000Medicaid
WV0052096000Medicaid
WVTO4093491Medicare PIN