Healthcare Provider Details

I. General information

NPI: 1194502880
Provider Name (Legal Business Name): ANNA KATE POPE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6326 PEAKE RD
MACON GA
31210-3960
US

IV. Provider business mailing address

203 LONDIE LN
PERRY GA
31069-4999
US

V. Phone/Fax

Practice location:
  • Phone: 478-254-6608
  • Fax: 478-254-6689
Mailing address:
  • Phone: 478-231-0017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12861
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: