Provider Demographics
NPI:1992820781
Name:ROPER, RICK B (DPM)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:B
Last Name:ROPER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2029 BLUEGRASS CIRCLE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7369
Mailing Address - Country:US
Mailing Address - Phone:307-778-7666
Mailing Address - Fax:307-632-4465
Practice Address - Street 1:2029 BLUEGRASS CIRCLE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7369
Practice Address - Country:US
Practice Address - Phone:307-778-7666
Practice Address - Fax:307-632-4465
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY144213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54569Medicaid
NMNMAAA1323Medicare PIN
T41093Medicare UPIN