Healthcare Provider Details

I. General information

NPI: 1619312956
Provider Name (Legal Business Name): JASON POU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1532 ROBERT E LEE BLVD
NEW ORLEANS LA
70122
US

IV. Provider business mailing address

1541 KINGS HWY
SHREVEPORT LA
71103-4228
US

V. Phone/Fax

Practice location:
  • Phone: 504-846-9646
  • Fax: 504-842-3979
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number82147
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number306655
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number306655
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: