Healthcare Provider Details

I. General information

NPI: 1245159821
Provider Name (Legal Business Name): DR. JOHN CARL PAULEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 FORE DR
AKRON OH
44313-4822
US

IV. Provider business mailing address

1817 FORE DR
AKRON OH
44313-4822
US

V. Phone/Fax

Practice location:
  • Phone: 304-502-2179
  • Fax:
Mailing address:
  • Phone: 304-502-2179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPRN.CNP.0042716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: