Healthcare Provider Details

I. General information

NPI: 1881606002
Provider Name (Legal Business Name): WESLEY EDWARD POPE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2818 NW 32ND ST
NEWCASTLE OK
73065-6576
US

IV. Provider business mailing address

PO BOX 892398
OKLAHOMA CITY OK
73189-2398
US

V. Phone/Fax

Practice location:
  • Phone: 405-387-4546
  • Fax: 405-387-4551
Mailing address:
  • Phone: 405-387-4546
  • Fax: 405-387-4551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number17440
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: