Provider Demographics
NPI:1982349205
Name:GOPPERT, HENRY L (DPM)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:L
Last Name:GOPPERT
Suffix:
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 1:6860 AMHERST DR APT 2005
Mailing Address - Street 2:
Mailing Address - City:SAGAMORE HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44067-3102
Mailing Address - Country:US
Mailing Address - Phone:816-585-2498
Mailing Address - Fax:
Practice Address - Street 1:6860 AMHERST DR APT 2005
Practice Address - Street 2:
Practice Address - City:SAGAMORE HILLS
Practice Address - State:OH
Practice Address - Zip Code:44067-3102
Practice Address - Country:US
Practice Address - Phone:816-585-2498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes211D00000XPodiatric Medicine & Surgery Service ProvidersAssistant, Podiatric