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General NPI Number Information
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NPI Number | 1093200263
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Entity Type | Individual
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Provider Name | CHRISTOPHER JACOB POPE
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Gender | Male
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 718 N MACOMB ST
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City | MONROE
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State | MI
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Zip | 48162-7815
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Country | US
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Telephone | 734-240-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 3170 KETTERING BLVD BUILDING B 3RD FLOOR
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City | MORAINE
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State | OH
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Zip | 45439-1924
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Country | US
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Telephone | 937-991-3188
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Fax | 937-223-9811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35.143315
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 4301116133
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License Number State | MI
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