Basic Information
| Provider Information | |||||||||
| NPI: | 1053383448 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POIRIER | ||||||||
| FirstName: | GIRARD | ||||||||
| MiddleName: | LUCIEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | NAVAL HOSPITAL JACKSONVILLE | ||||||||
| Address2: | 2080 CHILD STREET | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9045427340 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | NAVAL HOSPITAL JACKSONVILLE | ||||||||
| Address2: | 2080 CHILD STREET | ||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322140001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9045427340 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 11/30/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | ME94795 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00326260 | 01 | FL | RAILROAD MEDICARE | OTHER | 504708125A | 05 | GA | MEDICAID | 274843600 | 05 | FL | MEDICAID | 42072 | 01 | FL | FLBCBS | OTHER |