Provider Demographics
NPI:1326055757
Name:TOPE, JOHN JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JEFFREY
Last Name:TOPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1804 TORRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2575
Mailing Address - Country:US
Mailing Address - Phone:919-614-0984
Mailing Address - Fax:
Practice Address - Street 1:1804 TORRINGTON ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2575
Practice Address - Country:US
Practice Address - Phone:919-614-0984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24877208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC299278100OtherTRICARE
NC8364AOtherBLUE CROSS BLUE SHIELD
NC8364AOtherBLUE CROSS BLUE SHIELD
NC202559FMedicare ID - Type Unspecified