Poole, Stephanie Lynette
Poole, Stephanie Lynette is an sole proprietor health care provider with primary practice located at 611 Campbell Hill St Nw Ste 103 , Marietta GA 30060-1386. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Poole, Stephanie Lynette can be contacted via phone (770) 499-8909.Contact Information
Primary practice address
611 Campbell Hill St Nw Ste 103
Marietta GA 30060-1386
Phone: (770) 499-8909
Fax: (770) 499-8911
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 047011 | Georgia |
Profile Details
| NPI number | 1003983693 |
|---|---|
| LBN Legal business name | Poole, Stephanie Lynette |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 29th, 2006 |
| Last updated | Jan 31st, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003983693 | NPPES |
| Georgia | Other | 047011 | LICENSE |
| Georgia | Other | 412137622 | LICENSE |
| Georgia | MEDICAID | 000949044D | LICENSE |
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