Provider Demographics
NPI:1922299833
Name:SETH W. POIS, M.D., PSC
Entity Type:Organization
Organization Name:SETH W. POIS, M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:POIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-541-9763
Mailing Address - Street 1:1300 CLEAR SPRINGS TRCE STE 7
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3868
Mailing Address - Country:US
Mailing Address - Phone:502-425-5422
Mailing Address - Fax:
Practice Address - Street 1:1300 CLEAR SPRINGS TRCE STE 7
Practice Address - Street 2:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267542084P0800X, 2084P0804X
IN01041738A2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY10033000Medicaid
KY64267545Medicaid