MEDICARE: JOSEPH D PAZ D.O.

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	208VP0014X	Interventional Pain Medicine Physician	OS006388E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	826759	OTHER	PA	FIRST PRIORITY HEALTH
3	8749	OTHER	PA	GEISINGER

General Provider Information

NPI Number	:	1912907130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH D PAZ D.O.

Provider Business Mailing Address
First Line	:	1177 HIGHWAY 315 BLVD
Second Line	:	DOLPHIN PLAZA
City	:	WILKES BARRE
State	:	PA
Zip	:	18702-6928
Country	:	US
Telephone Number	:	570-270-5713
Fax Number	:	570-270-5719

Provider Business Practice Location Address
First Line	:	1177 HIGHWAY 315 BLVD
Second Line	:	DOLPHIN PLAZA
City	:	WILKES BARRE
State	:	PA
Zip	:	18702-6928
Country	:	US
Telephone Number	:	570-270-5713
Fax Number	:	570-270-5719

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	12/13/2021

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Directions to “ JOSEPH D PAZ D.O.” Practice Location

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