Provider Demographics
NPI:1538196449
Name:POPE, JOHN HENRY JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:POPE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 HIOAKS RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4043
Mailing Address - Country:US
Mailing Address - Phone:804-560-0490
Mailing Address - Fax:804-560-3424
Practice Address - Street 1:681 HIOAKS RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4043
Practice Address - Country:US
Practice Address - Phone:804-560-0490
Practice Address - Fax:804-560-3424
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101027856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
229892OtherSO HEALTH
VA1538196449Medicaid
269684OtherANTHEM
VA5699100Medicaid
229892OtherSO HEALTH
B05747Medicare UPIN
P00726320Medicare PIN
VA1538196449Medicaid