Provider Demographics
NPI:1194743963
Name:POHL, MARTIN NEVILLE (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:NEVILLE
Last Name:POHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MARTIN
Other - Middle Name:N
Other - Last Name:POHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-647-2900
Mailing Address - Fax:859-647-0140
Practice Address - Street 1:8726 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-9625
Practice Address - Country:US
Practice Address - Phone:859-647-2900
Practice Address - Fax:859-647-0140
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079990A207P00000X
KY21480207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2374336Medicaid
KY64214802Medicaid
KY50005473OtherPASSPORT
KY000000246759OtherANTHEM
KY930126010OtherRR-MEDICARE
KY50005473OtherPASSPORT
KY930126010OtherRR-MEDICARE