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General NPI Number Information
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NPI Number | 1750695722
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Entity Type | Organization
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Legal Business Name | PAUL L TESAR MD PC
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 1870A SAINT HELENS ST
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City | SAINT HELENS
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State | OR
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Zip | 97051-1736
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Country | US
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Telephone | 503-397-9038
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Fax | 503-397-7115
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Provider Business Mailing Address
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Address Line | PO BOX 929
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City | SAINT HELENS
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State | OR
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Zip | 97051-0929
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Country | US
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Telephone | 503-397-9038
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Fax | 503-397-7115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL LOUIS TESAR
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Credential | M.D.
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Telephone | 503-397-9038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD09962
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License Number State | OR
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