Healthcare Provider Details

I. General information

NPI: 1518970995
Provider Name (Legal Business Name): PAUL RICHARD ZIAYA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VETERANS AVE
BILOXI MS
39531-2410
US

IV. Provider business mailing address

4200 COCOLALLA LOOP RD
COCOLALLA ID
83813-9620
US

V. Phone/Fax

Practice location:
  • Phone: 228-523-5743
  • Fax:
Mailing address:
  • Phone: 208-265-9002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12775
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number12775
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: