Individual
MARY AVERY POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9321
(662) 293-1143
Mailing address
611 ALCORN DR, CORINTH, MS 38834-9321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T-3839
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2019
Last updated
06/28/2019
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