Provider Demographics
NPI:1174577712
Name:HOPPER, BRUCE DONALD JR (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DONALD
Last Name:HOPPER
Suffix:JR
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746723
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6723
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:5843 RISING SUN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1144
Practice Address - Country:US
Practice Address - Phone:215-437-0128
Practice Address - Fax:215-857-0419
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2025-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD421377207QS0010X, 2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine