Provider Demographics
NPI:1033102850
Name:POHL, JOSEPH F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:POHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MEDICAL CENTER BLVD.
Mailing Address - Street 2:SUITE 365
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3353
Mailing Address - Country:US
Mailing Address - Phone:770-962-0972
Mailing Address - Fax:
Practice Address - Street 1:500 MEDICAL CENTER BLVD.
Practice Address - Street 2:SUITE 365
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3353
Practice Address - Country:US
Practice Address - Phone:770-962-0972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2011-10-28
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-12
Provider Licenses
StateLicense IDTaxonomies
GA034441207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000478926DMedicaid
GA16BBBPDMedicare PIN
GAE95409Medicare UPIN