Provider Demographics
NPI:1922037191
Name:ROPP, JOHN CONWAY III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CONWAY
Last Name:ROPP
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:C
Other - Last Name:ROPP
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:420 W CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4524
Mailing Address - Country:US
Mailing Address - Phone:843-917-4977
Mailing Address - Fax:843-639-8145
Practice Address - Street 1:420 W CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4524
Practice Address - Country:US
Practice Address - Phone:843-917-4977
Practice Address - Fax:843-917-4968
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23144207QG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC231449Medicaid
SCH70022Medicare UPIN