Provider Demographics
NPI:1184647935
Name:POPE, THEODORE WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:WILLIAM
Last Name:POPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5701 W 119TH ST
Mailing Address - Street 2:SUITE 430
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3721
Mailing Address - Country:US
Mailing Address - Phone:913-253-3000
Mailing Address - Fax:913-663-2980
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 430
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3721
Practice Address - Country:US
Practice Address - Phone:913-253-3000
Practice Address - Fax:913-663-2980
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35077839P207RC0000X
NV12490207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOK67000047Medicare PIN