Provider Demographics
NPI:1700055779
Name:DRS JOPLING AND BRUNSON
Entity Type:Organization
Organization Name:DRS JOPLING AND BRUNSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOPLING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:706-595-3462
Mailing Address - Street 1:115 GORDON STREET
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824
Mailing Address - Country:US
Mailing Address - Phone:706-595-3462
Mailing Address - Fax:706-595-3616
Practice Address - Street 1:115 GORDON STREET
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824
Practice Address - Country:US
Practice Address - Phone:706-595-3462
Practice Address - Fax:706-595-3616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS JOPLING AND BRUNSON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA81291223G0001X
GA91441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty