Healthcare Provider Details

I. General information

NPI: 1467488296
Provider Name (Legal Business Name): JANICE L PAULEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 YANKEE PARK PL
DAYTON OH
45458-1868
US

IV. Provider business mailing address

1550 YANKEE PARK PL
DAYTON OH
45458-1868
US

V. Phone/Fax

Practice location:
  • Phone: 937-439-4949
  • Fax: 937-439-4948
Mailing address:
  • Phone: 937-439-4949
  • Fax: 937-439-4948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35057995
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number35.057995
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number35.057995
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number35.057995
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: