Individual
DR. TIMOTHY B POPHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1169 EASTERN PKWY, G58, LOUISVILLE, KY 40217
(502) 452-9567
(502) 473-0586
Mailing address
1169 EASTERN PKWY, G58, LOUISVILLE, KY 40217
(502) 452-9567
(502) 473-0586
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
21233
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1049205
PASSPORT
KY
05
—
64212335
—
KY
Enumeration date
11/29/2005
Last updated
05/08/2018
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