Provider Demographics
NPI:1811524143
Name:POPE, SARAH ANN (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:POPE
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 1:96 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1205
Mailing Address - Country:US
Mailing Address - Phone:845-430-1998
Mailing Address - Fax:
Practice Address - Street 1:507 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEWATER
Practice Address - State:WI
Practice Address - Zip Code:53190-1852
Practice Address - Country:US
Practice Address - Phone:262-473-0400
Practice Address - Fax:262-473-0408
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI77875207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program