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NPI Code Detail

MEDICARE: JOHN HAROLD PAULSON LISW

MEDICARE: JOHN HAROLD PAULSON LISW
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
11041C0700XClinical Social WorkerI-7336OH

General Provider Information

NPI Number : 1558392498
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN HAROLD PAULSON LISW
Provider Business Mailing Address
First Line : 5231 MEADOWKNOLL LN
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-2415
Country : US
Telephone Number : 614-459-4314
Fax Number :
Provider Business Practice Location Address
First Line : 40 SPRUCE ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-2204
Country : US
Telephone Number : 614-299-6600
Fax Number : 614-421-3111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 07/08/2007

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