MEDICARE: LARRY H PAUL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	13389	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300064449	OTHER	TN	RR MCARE- CI
2	3031080	OTHER	TN	ADR BC/BS OF TN
3	3049711	OTHER	TN	PLAZA BC/BS OF TN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	300046228	OTHER	TN	RR MCARE-ADR

General Provider Information

NPI Number	:	1265463038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY H PAUL MD

Provider Business Mailing Address
First Line	:	PO BOX 3146
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-3146
Country	:	US
Telephone Number	:	855-206-8406
Fax Number	:	855-823-8132

Provider Business Practice Location Address
First Line	:	210 25TH AVE N STE 602
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-1631
Country	:	US
Telephone Number	:	615-312-0600
Fax Number	:	615-320-3259

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	11/10/2018

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Directions to “ LARRY H PAUL MD” Practice Location

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