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General NPI Number Information
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NPI Number | 1134110430
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Entity Type | Individual
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Provider Name | DAVID J. PARIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 7980 W JEFFERSON BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46804-4170
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Country | US
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Telephone | 260-478-5280
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Fax | 260-458-3536
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Provider Business Mailing Address
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Address Line | 6920 POINTE INVERNESS WAY STE 200
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City | FORT WAYNE
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State | IN
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Zip | 46804-7934
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Country | US
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Telephone | 260-479-3516
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Fax | 260-479-3520
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01039725A
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License Number State | IN
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