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General NPI Number Information
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NPI Number | 1942396718
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Entity Type | Individual
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Provider Name | CLIFFORD ROBERT POPLAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 915 GENEVA STREET
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City | DELAVAN
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State | WI
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Zip | 53115
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Country | US
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Telephone | 262-728-2651
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Fax | 262-728-2728
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Provider Business Mailing Address
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Address Line | 915 E GENEVA ST PO BOX 467
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City | DELAVAN
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State | WI
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Zip | 53115-1922
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Country | US
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Telephone | 262-728-2651
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Fax | 262-728-2728
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 28415
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License Number State | WI
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