Provider Demographics
NPI:1457318743
Name:POOL, DOUGLAS STUART (MD PSYCHIATRIST PSYC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:STUART
Last Name:POOL
Suffix:
Gender:M
Credentials:MD PSYCHIATRIST PSYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CODIFER BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005
Mailing Address - Country:US
Mailing Address - Phone:504-835-6320
Mailing Address - Fax:504-836-6980
Practice Address - Street 1:300 CODIFER BLVD
Practice Address - Street 2:STE A
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005
Practice Address - Country:US
Practice Address - Phone:504-835-6320
Practice Address - Fax:504-836-6980
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP70281822084P0800X
LA39832084P0802X
LA0102782084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
B61139Medicare UPIN
LA5K969Medicare ID - Type Unspecified