Provider Demographics
NPI:1235123407
Name:POHL, JAY THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:THOMAS
Last Name:POHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:615 MYNATT STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640
Mailing Address - Country:US
Mailing Address - Phone:256-773-2979
Mailing Address - Fax:256-773-2986
Practice Address - Street 1:615 MYNATT STREET
Practice Address - Street 2:SUITE E
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640
Practice Address - Country:US
Practice Address - Phone:256-773-2979
Practice Address - Fax:256-773-2986
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00019023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000028289Medicaid
AL000028289Medicaid
ALF68004Medicare UPIN