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NPI Code Detail

MEDICARE: DR. JOHN G PAWLUS DDS

MEDICARE: DR. JOHN G PAWLUS DDS
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
1122300000XDentist12009682AIN

General Provider Information

NPI Number : 1710104930
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN G PAWLUS DDS
Provider Business Mailing Address
First Line : 4001 W GOELLER BLVD STE C
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-8309
Country : US
Telephone Number : 812-372-8590
Fax Number :
Provider Business Practice Location Address
First Line : 4001 W GOELLER BLVD STE C
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-8309
Country : US
Telephone Number : 812-372-8590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2007
Last Update Date : 02/07/2013

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Directions to “ DR. JOHN G PAWLUS DDS” Practice Location

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