MEDICARE: DR. SETH A POPE M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	023710	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	260050958	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10039389	OTHER	GA	AMERIGROUP
3	52238055	OTHER	GA	BCBS
5	0000744	OTHER	GA	VALUE OPTIONS

General Provider Information

NPI Number	:	1104952407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SETH A POPE M.D., P.C.

Provider Business Mailing Address
First Line	:	2150 PEACHFORD RD
Second Line	:	SUITE Q
City	:	ATLANTA
State	:	GA
Zip	:	30338-6520
Country	:	US
Telephone Number	:	770-455-1277
Fax Number	:	770-451-6130

Provider Business Practice Location Address
First Line	:	2150 PEACHFORD RD
Second Line	:	SUITE Q
City	:	ATLANTA
State	:	GA
Zip	:	30338-6520
Country	:	US
Telephone Number	:	770-455-1277
Fax Number	:	770-451-6130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	11/30/2011

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Directions to “ DR. SETH A POPE M.D., P.C.” Practice Location

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