Healthcare Provider Details

I. General information

NPI: 1114967684
Provider Name (Legal Business Name): JEFFREY D POOLE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 CAROTHERS PKWY STE 210
FRANKLIN TN
37067-6039
US

IV. Provider business mailing address

3024 BUSINESS PARK CIR
GOODLETTSVILLE TN
37072-3132
US

V. Phone/Fax

Practice location:
  • Phone: 615-861-1935
  • Fax: 629-209-9601
Mailing address:
  • Phone: 615-239-2018
  • Fax: 615-851-2018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM0000000636
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: