Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 4125 | TN |
N | 213EG0000X | General Practice | 4125 | TN |
Y | 1223X0400X | Orthodontists | 4125 | TN |
NPI | 1023009750 |
---|---|
Provider Name | Dr. Thomas W Popp |
First Address | Chattanooga, TN 37415-3113 |
Second Address | Chattanooga, TN 37415-3113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2005 |
Last Update Date | 05/11/2020 |