1477765691 NPI number — DANIEL M. POOLE D.C.P.A.

Table of content: (NPI 1477765691)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477765691 NPI number — DANIEL M. POOLE D.C.P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL M. POOLE D.C.P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477765691
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 SWAN HILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKLAND
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04963-4831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-465-4325
Provider Business Mailing Address Fax Number:
207-465-4335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 SWAN HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OAKLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04963-4831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-465-4325
Provider Business Practice Location Address Fax Number:
207-465-4335
Provider Enumeration Date:
05/03/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
POOLE
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
207-465-4325

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CR1232 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: CR1233 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1417998238 . This is a "NPI DR. ANGELA L HASTINGS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1548202831 . This is a "NPI DR. DANIEL M POOLE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".