Basic Information
Provider Information
NPI: 1184680977
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOPPER
FirstName: JOHN
MiddleName: ALEXANDER
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 0446 LOBBY J
Address2: 24 FRANK LLOYD WRIGHT DR. IHA
City: ANN ARBOR
State: MI
PostalCode: 48106
CountryCode: US
TelephoneNumber: 7347476766
FaxNumber: 7342223100
Practice Location
Address1: 5333 MCAULEY DR
Address2:  
City: YPSILANTI
State: MI
PostalCode: 481971014
CountryCode: US
TelephoneNumber: 7347123980
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/21/2006
LastUpdateDate: 02/25/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X4301064834MIY Allopathic & Osteopathic PhysiciansInternal Medicine 
207RA0401X4301064834MIN Allopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
208000000X4301064834MIN Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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