Provider Demographics
NPI:1417014309
Name:POIS, SETH WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:WARREN
Last Name:POIS
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 1:3810 ROCK BAY DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-2082
Mailing Address - Country:US
Mailing Address - Phone:502-425-5422
Mailing Address - Fax:
Practice Address - Street 1:1300 CLEAR SPRINGS TRCE
Practice Address - Street 2:SUITE 7
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3868
Practice Address - Country:US
Practice Address - Phone:502-425-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267542084P0804X, 2084P0800X
IN010417382084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64267545Medicaid
IN10033000Medicaid
611316280OtherFEIN