Dr. Stephanie Lynette Poole
Pediatrician
611 Campbell Hill St Nw Ste 103
Marietta
, Georgia 30060-1386
Dr. Stephanie Lynette Poole
Pediatrician
611 Campbell Hill St Nw Ste 103
Marietta
, Georgia 30060-1386
(770) 499-8911
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Dr. Stephanie Lynette Poole
- 611 Campbell Hill St. Ste. 103
- Marietta, GA
- Zip : 30060
- Fax : (770) 499-8911
- Phone : (770) 499-8909
Second Address
- Dr. Stephanie Lynette Poole
- 611 Campbell Hill St Nw Ste 103
- Marietta, GA
- Zip : 30060-1386
- Fax : (770) 499-8911
- Phone : (770) 499-8909
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 047011 | GA |
National Provider Identifier
| NPI | 1003983693 |
|---|---|
| Provider Name | Dr. Stephanie Lynette Poole |
| First Address | Marietta, GA 30060 |
| Second Address | Marietta, GA 30060-1386 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 29/11/2006 |
| Last Update Date | 31/01/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000949044D | (05) | GA |
| 047011 | LICENSE (01) | GA |
| 412137622 | TAX ID (01) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.