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General NPI Number Information
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NPI Number | 1174577712
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Entity Type | Individual
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Provider Name | BRUCE DONALD HOPPER JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 5843 RISING SUN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19120-1144
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Country | US
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Telephone | 215-437-0128
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Fax | 215-857-0419
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Provider Business Mailing Address
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Address Line | PO BOX 746723
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City | ATLANTA
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State | GA
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Zip | 30374-6723
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Country | US
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Telephone | 312-733-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | MD421377
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | MD421377
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License Number State | PA
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