Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | 08001418A | IN |
N | 213ER0200X | Radiology | 08001418A | IN |
Y | 111NR0400X | Rehabilitation Chiropractor | 08001418A | IN |
NPI | 1174611396 |
---|---|
Provider Name | Paul B Denis |
First Address | New Albany, IN 47150-9497 |
Second Address | New Albany, IN 47150-9497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 07/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U47308 | (02) | IN |