Provider Demographics
NPI:1073588331
Name:POPE, CRAIG D (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:POPE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 DILLON PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-2478
Mailing Address - Country:US
Mailing Address - Phone:636-677-3012
Mailing Address - Fax:636-677-3174
Practice Address - Street 1:1 DILLON PLAZA DR
Practice Address - Street 2:
Practice Address - City:HIGH RIDGE
Practice Address - State:MO
Practice Address - Zip Code:63049-2478
Practice Address - Country:US
Practice Address - Phone:636-677-3012
Practice Address - Fax:636-677-3174
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2014-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2002008188207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH76725Medicare UPIN