Healthcare Provider Details

I. General information

NPI: 1629381843
Provider Name (Legal Business Name): GERALD J ROPER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 STATE ROAD 229
BATESVILLE IN
47006-6808
US

IV. Provider business mailing address

1049 STATE ROAD 229
BATESVILLE IN
47006-6808
US

V. Phone/Fax

Practice location:
  • Phone: 812-934-9400
  • Fax: 812-933-0913
Mailing address:
  • Phone: 812-934-9400
  • Fax: 812-933-0913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0104380
License Number StateIN

VIII. Authorized Official

Name: DR. GERALD JAMES ROPER
Title or Position: OWNER
Credential: MD
Phone: 812-934-9400