MEDICARE: MR. JOSEPH R DUPPER DPM

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
1	213E00000X	Podiatrist	158	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07741	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1447326442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH R DUPPER DPM

Provider Business Mailing Address
First Line	:	2828 HIGHWAY 31 S STE 116
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35603-1538
Country	:	US
Telephone Number	:	256-340-1500
Fax Number	:	256-340-1566

Provider Business Practice Location Address
First Line	:	2828 HIGHWAY 31 S STE 116
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35603-1538
Country	:	US
Telephone Number	:	256-340-1500
Fax Number	:	256-340-1566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/01/2024

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Directions to “ MR. JOSEPH R DUPPER DPM” Practice Location

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