Healthcare Provider Details
I. General information
NPI: 1194743963
Provider Name (Legal Business Name): MARTIN NEVILLE POHL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8726 US HIGHWAY 42
FLORENCE KY
41042-9625
US
IV. Provider business mailing address
PO BOX 635283
CINCINNATI OH
45263-5283
US
V. Phone/Fax
- Phone: 859-647-2900
- Fax: 859-647-0140
- Phone: 859-647-2900
- Fax: 859-647-0140
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 01079990A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 21480 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: