Healthcare Provider Details

I. General information

NPI: 1609112283
Provider Name (Legal Business Name): PAUL R YAUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2012
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4237 CONCORD PIKE
WILMINGTON DE
19803-1403
US

IV. Provider business mailing address

4237 CONCORD PIKE
WILMINGTON DE
19803-1403
US

V. Phone/Fax

Practice location:
  • Phone: 302-477-1787
  • Fax: 302-477-1721
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number03-0000196
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: