Basic Information
| Provider Information | |||||||||
| NPI: | 1316173438 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOPPER | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | JUSTIN | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1869 | ||||||||
| Address2: | |||||||||
| City: | FLETCHER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287321869 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286875616 | ||||||||
| FaxNumber: | 8286508076 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL DR | ||||||||
| Address2: | C/O PARK RIDGE HOSPITAL | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287925272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8289746233 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2009 | ||||||||
| LastUpdateDate: | 05/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | DO3015 | ME | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 20969 | NH | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | 2012-01220 | NC | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | P01263435 | 01 | NC | RAIL ROAD MEDICARE | OTHER |