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General NPI Number Information
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NPI Number | 1972899276
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Entity Type | Individual
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Provider Name | DOUGLAS MICHAEL POKORNY D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | NAVAL MEDICAL CENTER 100 BREWSTER BLVD.
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City | CAMP LEJEUNE
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State | NC
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Zip | 28547
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Country | US
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Telephone | 910-450-4765
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Fax |
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Provider Business Mailing Address
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Address Line | NAVAL MEDICAL CENTER 100 BREWSTER BLVD.
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City | CAMP LEJEUNE
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State | NC
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Zip | 28547
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Country | US
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Telephone | 910-450-4765
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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 | 0102203196
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2019-01648
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 2019-01648
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 2019-01648
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | R3943
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License Number State | TX
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