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NPI Code Detail

MEDICARE: POPHEALTHCARE MEDICAL SERVICES OF AZ, PC

MEDICARE: POPHEALTHCARE MEDICAL SERVICES OF AZ, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician
2363LF0000XFamily Nurse Practitioner
3363L00000XNurse Practitioner

General Provider Information

NPI Number : 1154807469
Entity Type Code : Organization
Provider Name (Legal Business Name) : POPHEALTHCARE MEDICAL SERVICES OF AZ, PC
Provider Business Mailing Address
First Line : 113 SEABOARD LN STE 200B
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-8282
Country : US
Telephone Number : 800-793-7050
Fax Number : 877-358-8109
Provider Business Practice Location Address
First Line : 170 COMMERCE WAY STE 200
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-3272
Country : US
Telephone Number : 800-793-7050
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : SUSAN PORTER
Credential :
Telephone Number : 615-500-2199
Provider Enumeration Date : 07/19/2018
Last Update Date : 08/15/2024

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Directions to “POPHEALTHCARE MEDICAL SERVICES OF AZ, PC ” Practice Location

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