Individual
DR. THEODORE KOPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6720 GRELOT ROAD SUITE A, SUITE 1B, MOBILE, AL 36695-2676
(251) 633-5155
(251) 633-5125
Mailing address
6720 GRELOT ROAD SUITE A, MOBILE, AL 36695-2676
(251) 633-5155
(251) 633-5125
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
30966
AL
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
30966
AL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
30966
AL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
30966
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182198
—
AL
01
—
511-70139
BCBS OF AL
AL
Enumeration date
10/23/2007
Last updated
02/04/2021
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