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General NPI Number Information
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NPI Number | 1598791394
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Entity Type | Individual
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Provider Name | ROBERT SOPKO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 103 LANDMARK DR SUITE 100
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City | BELLEVUE
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State | KY
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Zip | 41073-1393
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Country | US
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Telephone | 859-431-0090
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Fax | 859-431-3168
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Provider Business Mailing Address
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Address Line | 334 THOMAS MORE PKWY SUITE 200
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3464
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Country | US
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Telephone | 859-957-1080
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Fax | 859-957-1085
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18590
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License Number State | KY
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