Provider Demographics
NPI:1457690877
Name:CLOPP, MATTHEW (BSN)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:CLOPP
Suffix:
Gender:M
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 E OLYMPIC DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5910
Mailing Address - Country:US
Mailing Address - Phone:405-812-6656
Mailing Address - Fax:
Practice Address - Street 1:128 E OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5910
Practice Address - Country:US
Practice Address - Phone:405-812-6656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist