Individual
DR. KEVIN L POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703
(479) 442-6266
(479) 521-3877
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R-4136
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100209160B
—
OK
05
—
117410001
—
AR
01
—
53627
AR BC/BS
AR
01
—
P00194624
RR MCR
AR
Enumeration date
06/23/2006
Last updated
06/20/2018
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