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General NPI Number Information
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NPI Number | 1740460039
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Entity Type | Organization
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Legal Business Name | RANDAL H PAUL PSC
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 05/07/2009
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Provider Practice Location Address
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Address Line | 1332 ANDREA ST
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3334
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Country | US
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Telephone | 270-842-6300
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Fax | 270-842-6303
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Provider Business Mailing Address
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Address Line | 1332 ANDREA ST
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3334
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Country | US
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Telephone | 270-842-6300
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Fax | 270-842-6303
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Authorized Official
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Title or Position | ASSISTANT
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Name | MS. KIM DISHON
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Credential |
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Telephone | 270-842-6300
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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 | 29638
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License Number State | KY
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