Healthcare Provider Details

I. General information

NPI: 1427047893
Provider Name (Legal Business Name): TARA M PAUL O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 SMELTER AVE NE
GREAT FALLS MT
59404-1927
US

IV. Provider business mailing address

511 CENTRAL AVE W
GREAT FALLS MT
59404-2848
US

V. Phone/Fax

Practice location:
  • Phone: 406-750-2055
  • Fax: 406-403-0276
Mailing address:
  • Phone: 406-760-2055
  • Fax: 406-403-0276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5662
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5436 T2347
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: