Provider Demographics
NPI:1538276290
Name:POINTON, JEAN F (MD)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:F
Last Name:POINTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 QUEEN CITY AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-2351
Mailing Address - Country:US
Mailing Address - Phone:541-265-0581
Mailing Address - Fax:541-574-6252
Practice Address - Street 1:36 SW NYE ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-3821
Practice Address - Country:US
Practice Address - Phone:541-265-4179
Practice Address - Fax:541-265-4194
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL247712084P0800X
ORMD1601512084P0800X
WI70-3202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL443BLOtherEMPIRE BCBS PROVIDER #
AL051519855OtherBCBS PROVIDER NUMBER
AL0007796548OtherAETNA PROVIDER NUMBER
AL051519855Medicaid
OR500651663Medicaid
AL504900OtherVALUEOPTIONS PROVIDER #
AL200617923OtherEIN NUMBER
AL051519855Medicaid
AL051519855Medicaid