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General NPI Number Information
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NPI Number | 1396043170
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Entity Type | Organization
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Legal Business Name | WILLIAM H POGUE, MD, LLC
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 40 HART ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1743
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Country | US
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Telephone | 860-224-7193
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Fax | 860-224-1005
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Provider Business Mailing Address
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Address Line | 40 HART ST
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City | NEW BRITAIN
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State | CT
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Zip | 06052-1743
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Country | US
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Telephone | 860-224-7193
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Fax | 860-224-1005
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM H POGUE
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Credential | MD
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Telephone | 860-224-7193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 018085
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License Number State | CT
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