Provider Demographics
NPI:1073576930
Name:POPE, TREASURE F (PA-C)
Entity Type:Individual
Prefix:
First Name:TREASURE
Middle Name:F
Last Name:POPE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 HOGAN RD
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:GA
Mailing Address - Zip Code:31789-4717
Mailing Address - Country:US
Mailing Address - Phone:229-392-1608
Mailing Address - Fax:
Practice Address - Street 1:839 HOGAN RD
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:GA
Practice Address - Zip Code:31789-4717
Practice Address - Country:US
Practice Address - Phone:229-392-1608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002756363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100002472BMedicaid
GA100002472CMedicaid
GA100002472AMedicaid