Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 37345 | AZ |
N | 2086S0105X | Surgery of the Hand | 01060625A | IN |
N | 2086S0105X | Surgery of the Hand | 39411 | KY |
NPI | 1518906544 |
---|---|
Provider Name | Paul S Mahoney |
First Address | Peoria, AZ 85381-4903 |
Second Address | Peoria, AZ 85381-4903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 07/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
837230 | (05) | AZ |
I62241 | (02) |