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POOLE DERMATOLOGY A PROFESSIONAL MEDICAL CORPORATION NPI 1215151790


NPI Information

NPI: 1215151790
Provider Name: POOLE DERMATOLOGY A PROFESSIONAL MEDICAL CORPORATION
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 19D1000709

Address:
111 VETERANS MEMORIAL BLVD
SUITE #406
METAIRIE, LA
ZIP 70005
Phone: (504) 838-8225
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POOLE DERMATOLOGY A PROFESSIONAL MEDICAL CORPORATION is a dermatology in Metairie, LA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. POOLE DERMATOLOGY A PROFESSIONAL MEDICAL CORPORATION NPI is 1215151790. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

111 VETERANS MEMORIAL BLVD
SUITE #406
METAIRIE, LA
ZIP 70005-028
Phone: (504) 838-8225
Fax: (504) 838-8233

The provider's authorized official is Jeffrey C Poole .
The authorized official title is Owner and has the following contact phone number (504) 838-8225.

The CLIA number assigned to this NPI record is 19D1000709 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/13/2007 and was last updated on 8/26/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyMD021909LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H52030MEDICARE UPIN
24A873MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA
31576387MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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