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NPI Code Detail

MEDICARE: PAUL G MENKE MD

MEDICARE: PAUL G MENKE 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
12085R0202XDiagnostic Radiology Physician23545TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285730416
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL G MENKE MD
Provider Business Mailing Address
First Line : PO BOX 1039
Second Line :
City : MURFREESBORO
State : TN
Zip : 37133-1039
Country : US
Telephone Number : 615-893-5022
Fax Number : 615-893-7184
Provider Business Practice Location Address
First Line : 212 HERITAGE PARK DR
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-1549
Country : US
Telephone Number : 615-893-5022
Fax Number : 615-893-7184
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 07/09/2007

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