Healthcare Provider Details
I. General information
NPI: 1013057355
Provider Name (Legal Business Name): JAMES H. POOLE, O.D.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2007
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
83745 HWY 9
ASHLAND AL
36251
US
IV. Provider business mailing address
PO BOX 1037
ASHLAND AL
36251-1037
US
V. Phone/Fax
- Phone: 256-354-2010
- Fax: 256-354-5324
- Phone: 256-354-2010
- Fax: 256-354-5324
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WL0500X |
| Taxonomy | Low Vision Rehabilitation Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WP0200X |
| Taxonomy | Pediatric Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WS0006X |
| Taxonomy | Sports Vision Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WV0400X |
| Taxonomy | Vision Therapy Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | S-641-TA-157 |
| License Number State | AL |
VIII. Authorized Official
Name: DR.
JAMES
H.
POOLE
Title or Position: OWNER
Credential: O.D.
Phone: 256-354-2010