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NPI Code Detail

MEDICARE: DR. BRYANT EMORY POOLE MD

MEDICARE: DR. BRYANT EMORY POOLE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician18517AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
30000340002OTHERALMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10366100001OTHERALMC NSC
20366100001OTHERALCIGNA GOVERNMENT SERVICES PTAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801869391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRYANT EMORY POOLE MD
Provider Business Mailing Address
First Line : 3485 INDEPENDENCE DR
Second Line :
City : HOMEWOOD
State : AL
Zip : 35209-5603
Country : US
Telephone Number : 205-930-0920
Fax Number : 205-445-0115
Provider Business Practice Location Address
First Line : 3485 INDEPENDENCE DR
Second Line :
City : HOMEWOOD
State : AL
Zip : 35209-5603
Country : US
Telephone Number : 205-930-0920
Fax Number : 205-445-0115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 04/01/2014

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Directions to “ DR. BRYANT EMORY POOLE MD” Practice Location

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