Provider Demographics
NPI:1508385428
Name:POPE MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:POPE MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:336-710-1949
Mailing Address - Street 1:172 W INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-3566
Mailing Address - Country:US
Mailing Address - Phone:336-415-5853
Mailing Address - Fax:
Practice Address - Street 1:172 W INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-3566
Practice Address - Country:US
Practice Address - Phone:336-415-5853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WP0000X, 291900000X, 291U00000X, 292200000X, 293D00000X
NC5006312207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No163WP0000XNursing Service ProvidersRegistered NursePain ManagementGroup - Multi-Specialty
No291900000XLaboratoriesMilitary Clinical Medical Laboratory
No291U00000XLaboratoriesClinical Medical Laboratory
No292200000XLaboratoriesDental Laboratory
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Multi-Specialty