MEDICARE: DR. ZACHARY BARTON POOLE MD

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
1	207W00000X	Ophthalmology Physician	2022-03075	NC
2	207W00000X	Ophthalmology Physician	MMD.89111	SC

General Provider Information

NPI Number	:	1790246585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZACHARY BARTON POOLE MD

Provider Business Mailing Address
First Line	:	121 BETHEL ST
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-1101
Country	:	US
Telephone Number	:	803-222-9538
Fax Number	:	803-222-1898

Provider Business Practice Location Address
First Line	:	121 BETHEL ST
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-1101
Country	:	US
Telephone Number	:	803-222-9538
Fax Number	:	803-222-1898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	06/06/2024

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