Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME133809 | FL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME133809 | FL |
NPI | 1336110006 |
---|---|
Provider Name | Craig A Popp |
First Address | Vero Beach, FL 32960-4800 |
Second Address | Vero Beach, FL 32960-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 11/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200034153 | RAILROAD MEDICARE (01) | |
CF2064 | RAILROAD GROUP (01) | IL |
G71070 | (02) |