Provider Demographics
NPI:1861252199
Name:POPE, JOE EARL
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:EARL
Last Name:POPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 GRAND HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2133
Mailing Address - Country:US
Mailing Address - Phone:313-401-6623
Mailing Address - Fax:
Practice Address - Street 1:12004 GRAND HAVEN ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2133
Practice Address - Country:US
Practice Address - Phone:313-401-6623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide