Healthcare Provider Details

I. General information

NPI: 1497311740
Provider Name (Legal Business Name): WILLIAM LEE ROPER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 03/08/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 MANNING DR
CHAPEL HILL NC
27514-4221
US

IV. Provider business mailing address

170 MANNING DR
CHAPEL HILL NC
27514-4221
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-6440
  • Fax: 919-966-3049
Mailing address:
  • Phone: 919-966-6440
  • Fax: 919-966-3049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2022-01807
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number250176
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: