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NPI Code Detail

MEDICARE: JOHN T BOPP PC

MEDICARE: JOHN T BOPP PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
21041C0700XClinical Social Worker
3103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1447292180
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN T BOPP PC
Provider Business Mailing Address
First Line : 6155 OAK ST
Second Line : SUITE E
City : KANSAS CITY
State : MO
Zip : 64113-2238
Country : US
Telephone Number : 816-333-0606
Fax Number : 816-523-5418
Provider Business Practice Location Address
First Line : 6155 OAK ST
Second Line : SUITE E
City : KANSAS CITY
State : MO
Zip : 64113-2238
Country : US
Telephone Number : 816-333-0606
Fax Number : 816-523-5418
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MARY ANN COTTRELL
Credential :
Telephone Number : 816-333-0606
Provider Enumeration Date : 06/10/2006
Last Update Date : 11/09/2007

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