Provider Demographics
NPI:1326312539
Name:POPE FAMILY MEDICAL CLINIC, PLLC
Entity Type:Organization
Organization Name:POPE FAMILY MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-942-1301
Mailing Address - Street 1:651 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-5000
Mailing Address - Country:US
Mailing Address - Phone:870-942-1301
Mailing Address - Fax:870-942-1305
Practice Address - Street 1:651 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-5000
Practice Address - Country:US
Practice Address - Phone:870-942-1301
Practice Address - Fax:870-942-1305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty