Healthcare Provider Details

I. General information

NPI: 1811213887
Provider Name (Legal Business Name): PAUL SPEICHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SIVLEY RD SW STE 300
HUNTSVILLE AL
35801-5102
US

IV. Provider business mailing address

930 FRANKLIN ST SE
HUNTSVILLE AL
35801-4312
US

V. Phone/Fax

Practice location:
  • Phone: 256-536-5594
  • Fax: 256-533-3379
Mailing address:
  • Phone: 256-533-3388
  • Fax: 256-801-6905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number38114
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: