Provider Demographics
NPI:1154492759
Name:POPE, WILLIAM BRUCE (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRUCE
Last Name:POPE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:W
Other - Middle Name:BRUCE
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:30 WALL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2710
Mailing Address - Country:US
Mailing Address - Phone:828-255-2220
Mailing Address - Fax:888-254-1865
Practice Address - Street 1:30 WALL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2710
Practice Address - Country:US
Practice Address - Phone:828-255-2220
Practice Address - Fax:888-254-1865
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1986152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5913108Medicaid
NCU25610Medicare UPIN
NC2474294Medicare PIN