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General NPI Number Information
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NPI Number | 1134338114
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Entity Type | Individual
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Provider Name | JOHN MARK POOL MD
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD STE 1E50
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City | NEWARK
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State | DE
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Zip | 19718-4409
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Country | US
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Telephone | 302-733-1980
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Fax | 302-733-1986
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Provider Business Mailing Address
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Address Line | PO BOX 3988
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City | CARBONDALE
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State | IL
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Zip | 62902-3988
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Country | US
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Telephone | 618-457-5200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | UNKNOWN
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 036166785
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | M6832
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | C1-0026347
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License Number State | DE
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