Individual
GINGER L POLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4566 S EASON BLVD, TUPELO, MS 38801-6540
(662) 377-4905
(662) 377-4906
Mailing address
PO BOX 3970, TUPELO, MS 38803-3970
(662) 377-4905
(662) 377-4906
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
02002641A
IN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
22214
MS
2080N0001X
Neonatal-Perinatal Medicine Physician
P2154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04738364
—
MS
Enumeration date
02/10/2006
Last updated
09/17/2020
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