Basic Information
| Provider Information | |||||||||
| NPI: | 1790986651 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOPPERI | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | ALISON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ERB | ||||||||
| OtherFirstName: | ANDREA | ||||||||
| OtherMiddleName: | ALISON | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 388 S MAIN ST | ||||||||
| Address2: | STE. 201 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443111064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307737866 | ||||||||
| FaxNumber: | 3307735090 | ||||||||
| Practice Location | |||||||||
| Address1: | 388 S MAIN ST | ||||||||
| Address2: | STE. 201 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443111064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307737866 | ||||||||
| FaxNumber: | 3307735090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 08/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 34009156 | OH | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2877589 | 05 | OH | MEDICAID | 4239802 | 01 | MEDICARE ID | OTHER |