Provider Demographics
NPI:1619953817
Name:SCHOPPE, JOHN J JR (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:SCHOPPE
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BASCOM CT STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2798
Mailing Address - Country:US
Mailing Address - Phone:772-834-4296
Mailing Address - Fax:706-221-2083
Practice Address - Street 1:113 BASCOM CT STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-2798
Practice Address - Country:US
Practice Address - Phone:706-221-2082
Practice Address - Fax:706-221-2083
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001546213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7089Medicare PIN
FLU89977Medicare UPIN