Provider Demographics
NPI:1013021542
Name:GREG D POUND DPM PA
Entity Type:Organization
Organization Name:GREG D POUND DPM PA
Other - Org Name:WOUND CARE SPECIALISTS OF SOUTHWEST FLORIDA PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:D
Authorized Official - Last Name:POUND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM FACAS
Authorized Official - Phone:239-267-9009
Mailing Address - Street 1:17595 S TAMIAMI TRL
Mailing Address - Street 2:STE 102
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-5308
Mailing Address - Country:US
Mailing Address - Phone:239-267-9009
Mailing Address - Fax:239-267-1319
Practice Address - Street 1:17595 S TAMIAMI TRL STE 102
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4500
Practice Address - Country:US
Practice Address - Phone:239-267-9009
Practice Address - Fax:239-267-1319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2844163WW0000X
FLPO 2844213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4766010001Medicare NSC