Provider Demographics
NPI:1659336287
Name:POOL, JOSEPH W (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:POOL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3535 FISHINGER BLVD
Mailing Address - Street 2:SUITE 285
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7504
Mailing Address - Country:US
Mailing Address - Phone:614-527-2562
Mailing Address - Fax:614-527-2571
Practice Address - Street 1:3535 FISHINGER BLVD
Practice Address - Street 2:SUITE 285
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7504
Practice Address - Country:US
Practice Address - Phone:614-457-5723
Practice Address - Fax:614-527-2571
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35076666207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2245074Medicaid
H36695Medicare UPIN
OH4050185Medicare PIN