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NPI Code Detail

MEDICARE: PAUL L AXTELL M.D.

MEDICARE: PAUL L AXTELL 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
1207X00000XOrthopaedic Surgery PhysicianC51380CA
2207X00000XOrthopaedic Surgery Physician213053-1NY
3207X00000XOrthopaedic Surgery Physician213053NY

Other Identifiers

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

General Provider Information

NPI Number : 1790786234
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL L AXTELL M.D.
Provider Business Mailing Address
First Line : 191 N MAIN ST
Second Line :
City : WELLSVILLE
State : NY
Zip : 14895-1150
Country : US
Telephone Number : 585-596-2054
Fax Number : 585-596-0147
Provider Business Practice Location Address
First Line : 191 N MAIN ST
Second Line :
City : WELLSVILLE
State : NY
Zip : 14895-1150
Country : US
Telephone Number : 585-596-2054
Fax Number : 585-596-0147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 06/29/2023

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