MEDICARE: DR. JANICE L PAULEY M.D.

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	207L00000X	Anesthesiology Physician	35057995	OH
2	208VP0000X	Pain Medicine Physician	35.057995	OH
3	208VP0014X	Interventional Pain Medicine Physician	35.057995	OH
4	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	35.057995	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1467488296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE L PAULEY M.D.

Provider Business Mailing Address
First Line	:	1550 YANKEE PARK PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-1868
Country	:	US
Telephone Number	:	937-439-4949
Fax Number	:	937-439-4948

Provider Business Practice Location Address
First Line	:	1550 YANKEE PARK PL
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45458-1868
Country	:	US
Telephone Number	:	937-439-4949
Fax Number	:	937-439-4948

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	03/17/2014

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Directions to “ DR. JANICE L PAULEY M.D.” Practice Location

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