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General NPI Number Information
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NPI Number | 1205164282
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Entity Type | Organization
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Legal Business Name | BERNARD T. POOLE, MD, PA
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 818 N EMPORIA ST SUITE 107
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City | WICHITA
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State | KS
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Zip | 67214-3729
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Country | US
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Telephone | 316-264-2806
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Fax | 316-264-4716
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Provider Business Mailing Address
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Address Line | 818 N EMPORIA ST SUITE 107
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City | WICHITA
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State | KS
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Zip | 67214-3729
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Country | US
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Telephone | 316-264-2806
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Fax | 316-264-4716
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Authorized Official
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Title or Position | OWNER
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Name | BERNARD T POOLE
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Credential | MD
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Telephone | 316-264-2806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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