Provider Demographics
NPI:1740248012
Name:DAVID A. POMIERSKI, MD, PA
Entity type:Organization
Organization Name:DAVID A. POMIERSKI, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:POMIERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-703-9231
Mailing Address - Street 1:P.O. DRAWER 110
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-0110
Mailing Address - Country:US
Mailing Address - Phone:601-703-9506
Mailing Address - Fax:601-703-3264
Practice Address - Street 1:1800 12TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4158
Practice Address - Country:US
Practice Address - Phone:601-703-9231
Practice Address - Fax:601-703-6794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06577771Medicaid
125359400OtherUS DEPT OF LABOR W/C
DA6541OtherRAILROAD MEDICARE
AL529917980Medicaid
AL529917980Medicaid
C03018Medicare ID - Type Unspecified
5193020001Medicare NSC