P George Poore, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5778A Issued in WY

Practice address

555 East Broadway Ste 212
Jackson, WY 83001-4777

Phone

(307) 739-4662

Fax

(307) 733-7679

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531
  NPD (past)
• Teton Valley Health Care Inc

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295878783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4777",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830014777",
            "telephone_number": "307-739-4662",
            "fax_number": "307-733-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 EAST BROADWAY STE 212",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830014777",
            "telephone_number": "307-739-4662",
            "fax_number": "307-733-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORE",
        "first_name": "P",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WY",
            "license": "5778A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vita Picchi, LAC
• Amy Pitman, L.C.S.W.
• Thomas J Pockat, M.D.
• Mark B Pommer, ED.M
• Kristin Poole
• Gary Post, MSW
• Lisa Marie Potzernitz
• Brian Charles Prax, MA PT
• Madison Prescott, RBT
• Natalie Prescott, MS, PPC

• Surgery Physician in Jackson, WY
• Providers in Jackson, WY by specialty
• Surgery Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.