Healthcare Provider Details

I. General information

NPI: 1700310943
Provider Name (Legal Business Name): STEPHEN KYLE PAUL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEPHEN PAUL

II. Dates (important events)

Enumeration Date: 04/14/2017
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 N MAIN ST
SPRINGBORO OH
45066-9552
US

IV. Provider business mailing address

5887 SPINNEY CT
SPRINGBORO OH
45066-3500
US

V. Phone/Fax

Practice location:
  • Phone: 937-883-5598
  • Fax: 937-915-0908
Mailing address:
  • Phone: 937-477-1597
  • Fax: 937-915-0908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number34.015740
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34.015740
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number34.015740
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: