Provider Demographics
NPI:1508119900
Name:POPE, DAPHNE H (MS)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:H
Last Name:POPE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 CHARTER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-3406
Mailing Address - Country:US
Mailing Address - Phone:229-834-6162
Mailing Address - Fax:
Practice Address - Street 1:1614 CHARTER OAKS DR
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-3406
Practice Address - Country:US
Practice Address - Phone:229-834-6162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator