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General NPI Number Information
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NPI Number | 1700056579
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Entity Type | Organization
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Legal Business Name | PAUL R. HONAN, JR MD INC
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 09/25/2009
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Provider Practice Location Address
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Address Line | 1720 N LEBANON ST
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City | LEBANON
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State | IN
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Zip | 46052-1501
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Country | US
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Telephone | 765-482-1954
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Fax | 765-482-5660
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Provider Business Mailing Address
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Address Line | 1720 N LEBANON ST
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City | LEBANON
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State | IN
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Zip | 46052-1501
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Country | US
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Telephone | 765-482-1954
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Fax | 765-482-5660
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL R HONAN JR.
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Credential | M.D.
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Telephone | 765-482-1954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01015185
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License Number State | IN
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