MEDICARE: DR. PAUL JOSEPH SCHIFANELLA O.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	152W00000X	Optometrist	SA44TA614	AL

General Provider Information

NPI Number	:	1750470902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL JOSEPH SCHIFANELLA O.D.

Provider Business Mailing Address
First Line	:	5358A HIGHWAY 17
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-3604
Country	:	US
Telephone Number	:	205-664-7577
Fax Number	:	205-664-7654

Provider Business Practice Location Address
First Line	:	5358A HIGHWAY 17
Second Line	:
City	:	HELENA
State	:	AL
Zip	:	35080-3604
Country	:	US
Telephone Number	:	205-664-7577
Fax Number	:	205-664-7654

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/25/2009

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