Healthcare Provider Details

I. General information

NPI: 1225096563
Provider Name (Legal Business Name): PAUL ALAN AUPPERLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 11/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 W ROSE GARDEN LN
PHOENIX AZ
85027-2530
US

IV. Provider business mailing address

2323 W ROSE GARDEN LN
PHOENIX AZ
85027-2530
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-6200
  • Fax: 623-842-5640
Mailing address:
  • Phone: 602-521-6200
  • Fax: 623-842-5640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number30485
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number30485
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: