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General NPI Number Information
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NPI Number | 1619498763
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Entity Type | Individual
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Provider Name | JACOB MARION POOLE MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 8845 N MILITARY TRL STE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6290
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Country | US
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Telephone | 561-763-7629
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Fax |
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Provider Business Mailing Address
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Address Line | 8845 N MILITARY TRL STE 200
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6290
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LL51186
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME149689
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License Number State | FL
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