Provider Demographics
NPI:1518320456
Name:POOLE, EMMILY JANE (MD)
Entity type:Individual
Prefix:DR
First Name:EMMILY
Middle Name:JANE
Last Name:POOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMMA
Other - Middle Name:JANE
Other - Last Name:TKACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:217 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1844
Mailing Address - Country:US
Mailing Address - Phone:858-231-5095
Mailing Address - Fax:
Practice Address - Street 1:2755 HERNDON AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6800
Practice Address - Country:US
Practice Address - Phone:559-324-4026
Practice Address - Fax:559-324-3730
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA159552207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine