Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO2844 | FL |
NPI | 1063608610 |
---|---|
Provider Name | Greg D Pound |
First Address | Oxford, MS 38655-1233 |
Second Address | Fort Myers, FL 33908-5308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 06/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
65674 | BCBS (01) | FL |