Provider Demographics
NPI:1013019686
Name:PARIS, ALLAN JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:
Last Name:PARIS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3507
Mailing Address - Country:US
Mailing Address - Phone:269-660-8844
Mailing Address - Fax:269-660-8844
Practice Address - Street 1:115 CASCADE DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3507
Practice Address - Country:US
Practice Address - Phone:269-660-8844
Practice Address - Fax:269-660-8844
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010064272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3262868Medicaid
E39176Medicare UPIN