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NPI Code Detail

MEDICARE: DR. RICHARD J POPP M.D.

MEDICARE: DR. RICHARD J POPP M.D.
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
1207Q00000XFamily Medicine Physician036061263IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194790675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD J POPP M.D.
Provider Business Mailing Address
First Line : 1506 W GARFIELD AVE
Second Line :
City : BARTONVILLE
State : IL
Zip : 61607-1755
Country : US
Telephone Number : 309-697-2416
Fax Number : 309-697-2749
Provider Business Practice Location Address
First Line : 1506 W GARFIELD AVE
Second Line :
City : BARTONVILLE
State : IL
Zip : 61607-1755
Country : US
Telephone Number : 309-697-2416
Fax Number : 309-697-2749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 02/23/2010

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Directions to “ DR. RICHARD J POPP M.D.” Practice Location

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