Provider Demographics
NPI:1356903421
Name:POOLE, WILLIAM BRANDON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:BRANDON
Last Name:POOLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 589
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-0589
Mailing Address - Country:US
Mailing Address - Phone:318-992-3208
Mailing Address - Fax:
Practice Address - Street 1:11973 HWY 84 W
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-7134
Practice Address - Country:US
Practice Address - Phone:318-992-5565
Practice Address - Fax:318-992-5599
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist