Healthcare Provider Details

I. General information

NPI: 1295733426
Provider Name (Legal Business Name): JAMES S POPE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 RANDOLPH ST STE 4
THOMASVILLE NC
27360-5731
US

IV. Provider business mailing address

1040 RANDOLPH ST SUITE 32
THOMASVILLE NC
27360-6383
US

V. Phone/Fax

Practice location:
  • Phone: 336-475-0151
  • Fax:
Mailing address:
  • Phone: 336-475-0143
  • Fax: 336-472-6831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1023
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: