Provider Demographics
NPI:1598749988
Name:POPE, JAMES C (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:POPE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:157 CLINIC AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-4413
Mailing Address - Country:US
Mailing Address - Phone:770-834-3336
Mailing Address - Fax:770-832-2196
Practice Address - Street 1:157 CLINIC AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-4413
Practice Address - Country:US
Practice Address - Phone:770-834-3336
Practice Address - Fax:770-832-2196
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GA13236208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00151214AMedicaid
GA30117A002OtherCHAMPUS
GA5623069OtherAETNA
GA143234OtherBLUE CROSS
GA143234OtherBLUE CROSS