Provider Demographics
NPI:1255375267
Name:POU, ANNA MARIA (MD)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:POU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 ESSEN LN
Mailing Address - Street 2:MBPERKINS, 4TH FLOOR, SUITE A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3738
Mailing Address - Country:US
Mailing Address - Phone:225-765-1765
Mailing Address - Fax:225-765-1768
Practice Address - Street 1:4950 ESSEN LN
Practice Address - Street 2:MBPERKINS, 4TH FLOOR, SUITE A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3738
Practice Address - Country:US
Practice Address - Phone:225-765-1765
Practice Address - Fax:225-765-1768
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.020910207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1465518Medicaid
MS07532018Medicaid
MS07532018Medicaid
LA4J225CW42Medicare PIN
LA1465518Medicaid
4J225DD21Medicare PIN