Healthcare Provider Details

I. General information

NPI: 1497539605
Provider Name (Legal Business Name): PAUL HOUILLION
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6012 TURNING LEAF WAY
MAINEVILLE OH
45039-7800
US

IV. Provider business mailing address

6012 TURNING LEAF WAY
MAINEVILLE OH
45039-7800
US

V. Phone/Fax

Practice location:
  • Phone: 513-415-2429
  • Fax:
Mailing address:
  • Phone: 513-415-2429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: