Provider Demographics
NPI:1265603849
Name:LOPE, LEA ANN (DO)
Entity type:Individual
Prefix:DR
First Name:LEA ANN
Middle Name:
Last Name:LOPE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 PELLIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4592
Mailing Address - Country:US
Mailing Address - Phone:724-836-0190
Mailing Address - Fax:724-837-4350
Practice Address - Street 1:516 PELLIS RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4592
Practice Address - Country:US
Practice Address - Phone:724-836-0190
Practice Address - Fax:724-837-4350
Is Sole Proprietor?:No
Enumeration Date:2008-03-21
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014845207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102373776Medicaid
PA102373776Medicaid