Healthcare Provider Details

I. General information

NPI: 1104514314
Provider Name (Legal Business Name): KEITH THOMAS BOPF JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1261 ROUTE 9 S STE 4
CAPE MAY COURT HOUSE NJ
08210-2761
US

IV. Provider business mailing address

74 CORSONS TAVERN RD
OCEAN VIEW NJ
08230-1601
US

V. Phone/Fax

Practice location:
  • Phone: 609-465-5599
  • Fax:
Mailing address:
  • Phone: 609-675-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00393900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: