Poole, Jeremy W

Poole, Jeremy W is an individual health care provider with primary practice located at 951 S Broad St , Thomasville GA 31792-6161. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Poole, Jeremy W can be contacted via phone (229) 228-4130.

Contact Information

Primary practice address
951 S Broad St Thomasville GA 31792-6161
Phone: (229) 228-4130
Fax: (229) 226-4690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 033433 Georgia

Profile Details

NPI number 1548343593
LBN Legal business name Poole, Jeremy W
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Mar 23rd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548343593 NPPES
Georgia Other 024957 BCBS PROVIDER NUMBER
Georgia Other 11DO266342 BCBS PROVIDER NUMBER
Georgia MEDICAID 728528012C BCBS PROVIDER NUMBER
Georgia Other GRP1474 BCBS PROVIDER NUMBER
Georgia Other 0001417567 10 BCBS PROVIDER NUMBER

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