Provider Demographics
NPI:1528089794
Name:FOROPOULOS, JOHN ERIC (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ERIC
Last Name:FOROPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:611 ALCORN DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9321
Mailing Address - Country:US
Mailing Address - Phone:662-286-6369
Mailing Address - Fax:662-286-2768
Practice Address - Street 1:611 ALCORN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9302
Practice Address - Country:US
Practice Address - Phone:662-286-6369
Practice Address - Fax:662-286-2768
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS12912207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00113668Medicaid
MS200000203Medicare PIN
F78707Medicare UPIN