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General NPI Number Information
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NPI Number | 1780553156
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Entity Type | Individual
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Provider Name | NOAH POGUE RN
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Gender | Male
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 778 LIBERTY RD
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City | FLOWOOD
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State | MS
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Zip | 39232-9300
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Country | US
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Telephone | 769-243-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 720 CLARKE COUNTY ROAD 370
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City | ENTERPRISE
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State | MS
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Zip | 39330
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Country | US
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Telephone | 601-701-3476
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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 | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 912718
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License Number State | MS
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