Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD19597 | OR |
N | 207Q00000X | Family Doctor | MD19597 | OR |
N | 207QS0010X | Family Doctor - Sports Medicine | MD19597 | OR |
NPI | 1023044021 |
---|---|
Provider Name | Dr. Reed E. Paulson |
First Address | Lebanon, OR 97355-4363 |
Second Address | Lebanon, OR 97355-4363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F10872 | (02) | OR |