Organization
GARY L. POOLE
Active
Other names
Stamps Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY L. POOLE APN (OWNER)
(870) 533-8808
Entity
Organization
Contact information
Practice address
218 CHURCH ST, STAMPS, AR 71860-2816
(870) 533-8808
(870) 533-8838
Mailing address
218 CHURCH ST, STAMPS, AR 71860-2816
(870) 533-8808
(870) 533-8838
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AO1177
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1316914724
PROVIDER INDIVIDUAL NPI#
—
05
—
150962762
—
AR
01
—
5C958
BLUE CROSS AND BLUE SHIEL
AR
01
—
5J597
BCBS
AR
01
—
P00115264
RAILROAD MEDICARE
—
Enumeration date
03/27/2007
Last updated
06/24/2008
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