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NPI Code Detail

MEDICARE: DR. PAUL J NINER III MD

MEDICARE: DR. PAUL J NINER III 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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianMD19376TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649286873
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL J NINER III MD
Provider Business Mailing Address
First Line : 4126 CHANCELLOR DR
Second Line :
City : THOMPSONS STATION
State : TN
Zip : 37179-5310
Country : US
Telephone Number : 615-838-2566
Fax Number :
Provider Business Practice Location Address
First Line : 621 W MAIN ST
Second Line :
City : HOHENWALD
State : TN
Zip : 38462-1355
Country : US
Telephone Number : 931-796-3245
Fax Number : 931-796-2315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 04/13/2012

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