Provider Demographics
NPI:1447275573
Name:DOPPS, RICHARD L (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:DOPPS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 189TH CIR W
Mailing Address - Street 2:
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052-9499
Mailing Address - Country:US
Mailing Address - Phone:316-794-7790
Mailing Address - Fax:
Practice Address - Street 1:1001 W 47TH ST S
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67217
Practice Address - Country:US
Practice Address - Phone:316-522-1122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU63225Medicare UPIN
KS055037Medicare ID - Type UnspecifiedMEDICARE PROVIDER #