Provider Demographics
NPI:1295018398
Name:POHL, ALAN LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LAWRENCE
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 1:6831 N LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3622
Mailing Address - Country:US
Mailing Address - Phone:414-352-9249
Mailing Address - Fax:414-352-9246
Practice Address - Street 1:6831 N LAKE DR
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-3622
Practice Address - Country:US
Practice Address - Phone:414-352-9249
Practice Address - Fax:414-352-9246
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18346-20261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical